Issue 7/2026
Popova, I., Drenovska, К.
Department of Dermatology and Venereology, Medical University – Sofia
Eyelid eczema is a common inflammatory disorder of the periocular skin characterized by pruritus, erythema, scaling, dryness, and edema. Despite its limited anatomical localization, it remains a significant diagnostic challenge because of its diverse etiology and its clinical resemblance to various dermatological and ophthalmological conditions. Allergic contact dermatitis is the leading cause of eyelid eczema, followed by atopic dermatitis and irritant contact dermatitis. Common allergens include fragrances, preservatives, metals, acrylates, cosmetic products, and ophthalmic medications. The diagnostic approach is based on detailed history taking, clinical examination, and assessment of potential exposures. In chronic, recurrent, or treatment-resistant cases, patch testing remains the gold standard for identifying the causative allergen. Treatment focuses on allergen avoidance, restoration of the skin barrier, and anti-inflammatory therapy. Early identification of the underlying cause is crucial for preventing recurrences and achieving long-term disease control.
Key words: eyelid eczema, periocular dermatitis, allergic contact dermatitis, atopic dermatitis, patch testing.
Address for correspondence:
Dr. Inna Popova
Department of Dermatology and Venereology,
MU – Sofia UMHAT “Alexandrovska” EAD
1, „St. Georgi Sofiiski”, Str.
1431, Sofia e-mail: inna.popova@mail.bg