Eczema of the eyelids.

ECZEMA may be defined as a particular type of catarrhal inflammation of the skin, manifesting itself as vesication, weeping, or thickening of the epidermis. It can be caused by substances reaching the skin from outside the body (contact eczema or dermatitis), the subsequent reaction resulting either from a simple primary irritant effect or from an allergic mechanism. Patch tests are applicable to the latter form alone. When the causative substance is a medicament, the condition is called dermatitis medicamentosa. In the absence of a demonstrable external cause, the condition is known as constitutional eczema, and nowadays, when the main factor appears to be mental stress, is frequently termed neurodermatitis. Infective eczema or dermatitis (infectious eczematoid dermatitis) is thought to result from the irritant or allergic effect of the products of micro-organisms on the surface of the skin. Finally, any eczematous process, whether contact or constitutional, can cause a sympathetic eruption in a distant area of the skin, and patients not uncommonly report complaining only of the secondary eruption. The eyelids are particularly susceptible to eczema, but this condition has been largely neglected in the literature. Theodore (1954, 1955) discussed some of the possible causes and Tzanck (1949) detailed the factors responsible in thirty cases of contact dermatitis. Swinny (1951) analysed 63 cases of contact dermatitis in which the eyelids were involved, though not necessarily primarily. The present paper attempts to evaluate the incidence of eczema of the eyelids in ophthalmological-practice, together with the relative frequency of the various types.