What is the cause of intermittently itchy eyelids?

Itchy eyelids have bothered a 26-year-old woman intermittently for several years.

Which of the conditions in the differential is the most likely cause?

A. Seborrhea.
B. Psoriasis.
C. Atopic dermatitis.
D. Contact dermatitis.
E. Dermatomyositis.

(Answer on next page.)
 

Answer: Atopic dermatitis


The presence of infraorbital folds supports the diagnosis of atopic dermatitis, C. The patient has a history of seasonal allergies and sensitive skin. Rubbing caused the erythema around the eyes. The heliotrope, or purplish, color—which is seen in dermatomyositis as well—results from venous congestion. Seborrhea and sebopsoriasis usually feature some scale and typically involve the medial half of the eyelid more than the lateral aspect.