Monday, November 24, 2008

Dennie Morgan Lines

Abstract: 4 yo boy with severe atopic dermatitis
History: 4 yo boy with severe atopic dermatitis. He's had severe atopic dermatitis since infancy and has asthma as well
O/E: The clinical picture shows classical Dennie Morgan Lines
Clinical Photo:

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Lab: N/A
Histopathology: N/A
Diagnosis or DDx: Dennie-Morgan Lines of Atopic Dermatitis
Questions: None
Reason(s) Presented: Strictly for interest
References: Dennie-Morgan lines are symmetrical, depression folds that lie just beneath the lower eyelids of atopic dermatitis patients. These usually present at birth or shortly after, but not in all atopic dermatititis patients. Allergic shiners, such as darkening under the eyes can also be seen, but most often, there is periorbital edema/swelling and lichenification/hardening of the skin.

Uehara M. Infraorbital fold in atopic dermatitis. Arch Dermatol. 1981 Oct;117(10):627-9
An infraorbital fold (Dennie-Morgan fold) occurred in 74 (25%) of 300 patients with atopic dermatitis. Lower eyelid dermatitis was initially seen in 69 (23%) of these 300 patients. Of the 69 patients with lower eyelid dermatitis, 57 (83%) showed the infraorbital fold. However, such a fold was seen only in 17 (7%) of 231 patients who lacked lower eyelid dermatitis. An infraorbital fold also was observed in eight of 11 patients with contact dermatitis of the lower eyelid. Thus, it is likely that an infraorbital fold develops when the lower eyelid is affected with eczematous dermatoses of diverse origins. The frequent occurrence of an infraorbital fold in patients with atopic dermatitis may be caused by the fact that the eyelid is a site of predilection for this dermatitis

11/25/08: 15 yo girl presented for eyelid dermatitis which shows Dennie-Morgan lines and atopic shiner. She has a long history of eczema and asthma.

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