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Chronic Eyelid Dermatitis Secondary to Cocamidopropyl Betaine Allergy in a Patient Using Baby Shampoo Eyelid Scrubs

John D. Welling, MD1; Thomas F. Mauger, MD1; Lynn R. Schoenfield, MD1; Andrew J. Hendershot, MD1
[+] Author Affiliations
1Havener Eye Institute, The Ohio State University Wexner Medical Center, Columbus
JAMA Ophthalmol. 2014;132(3):357-359. doi:10.1001/jamaophthalmol.2013.6254.
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The allergenic role of cocamidopropyl betaine (CAPB) in contact dermatitis, including eyelid dermatitis, is well documented in the dermatology literature. Despite widespread use of this surfactant in many cosmetic and self-care products, including some commonly prescribed by ophthalmologists for eyelid hygiene, we found no mention of this allergen in the ophthalmic literature.

Article InformationCorresponding Author: Andrew J. Hendershot, MD, Havener Eye Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Rd, Ste 5000, Columbus, OH 43212 (andrew.hendershot@osumc.edu).

Published Online: January 9, 2014. doi:10.1001/jamaophthalmol.2013.6254.

Author Contributions: Dr Welling had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Welling, Mauger, Hendershot.

Acquisition of data: Welling, Mauger, Hendershot.

Analysis and interpretation of data: Welling, Mauger, Schoenfield.

Drafting of the manuscript: Welling, Mauger, Schoenfield.

Critical revision of the manuscript for important intellectual content: Welling, Mauger, Hendershot.

Administrative, technical, or material support: All authors.

Study supervision: Mauger, Hendershot.

Conflict of Interest Disclosures: None reported.

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Figure 1.
Slitlamp Photograph

Slitlamp photograph of the left eye shows eyelid thickening, madarosis, and fissuring of the lateral canthi.

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Figure 2.
Conjunctival Biopsy Findings

A, Histopathology shows marked acute and chronic inflammation. Spongiosis and focal ulceration of squamous epithelium are seen (hematoxylin-eosin, original magnification ×20). B, High-power magnification shows a few eosinophils (below center) (hematoxylin-eosin, original magnification ×40).

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