Periocular Paederus dermatitis mimicking preseptal cellulitis.

OBJECTIVE

To introduce clinical and demographic characteristics of our patients with periocular Paederus dermatitis.

DESIGN

Retrospective study.

PARTICIPANTS

Thirteen patients diagnosed with periocular Paederus dermatitis.

METHODS

We included patients who presented to our ophthalmology clinic with pain, hyperemia, and tenderness on the eyelids, and were diagnosed with Paederus dermatitis based on clinical characteristics on dermatologic and ophthalmologic evaluation. Mean age was 31.5 years, and 31% of patients were female.

RESULTS

Subjective complaints included burning and epiphora in 85% and itching in 15% of the patients. Clinical findings on the eyelid skin were erythematous patches and plaques with multiple pustules (69%), erosions and bulla remnants on an erythematous base (7.7%), squamous and crusted patches and plaques (15%), and erythematous patches (7.7%). In 85% of the patients, similar lesions were detected on the other parts of the face. The treatment comprised wet dressings, weak steroid ointments for erythematous areas, and antibiotic ointments for crusted areas. Fifteen percent of the patients received methyl-prednisolone because they had significant periorbital edema. The lesions had improved in all patients at the 1-week visit after treatment.

CONCLUSIONS

Paederus dermatitis should be considered in the differential diagnosis of periocular infections and preseptal cellulitis. Meticulous questioning is of utmost importance for correct diagnosis and may prevent unnecessary systemic antibiotic use.