severe swelling, hives red, raised lesion, severe itching.

Secondary to histamine relaease and vasodilation

Oral antihistamine,

cool compresses

if systemic associations: oral steroids.

anthrax, 

disease of the skin of the lid

1. Cutaneous
2. respiratory
3. intestinal

Onset: for cuteonus as early as 1-2 days, occurs within the first 2 weeks fo exposure.

painless red macular rasth (flat distinct colored) that form papules which becomes bullae (blister) ulcerates to give Classic black eschar (black necrotic ulceration), eschar will sloughs in 2 to 4weeks, granulation tissue forms leads to

scarring

80-90% spontaneously heal

10-20% fatal due to speticemia, shock and renal failure.

Prevention: vaccine 3 sub q injections given 2 wks apart followed by boosters at 6,12, 18 monts

Penicillin G via IV (for systemic or visceral form),

oral doxycycline, ciprofloxacin and amoxicillin.

surgical repir,

possible graft 6 mos after the eschnar heals

similar presentation as preseptal cellulitis, except:

no demarcation line ( preseptal usually has a line where it looks self limiting, no tenderness, usually no pain, itching, no suppuration,

slight injxn & redness,

anterior chamber response variable

conjuntival chancre

madarosis

scleritis

interstitial keratitis.

secondary and primary lid lesions

Elephantiasis,

disease of the skin of the lid

Hypertrophy of lids and subcutaneous tissue,

rare PARASITC infxn,

surge of lymphatic fluid in sub-Q tissue along with severe allergic response to parasite --> severe edima

widespread dermatitis that may become exfoliative (skin falls off) and necrotic --> severe scarring.

Contract by firect contact,

self-limited,

secondary to to small pox vaccine (lid comtaminated from vaccination site.

Vitiligo,

disease of the skin of the lid

Leudoderma: white skin

Poliosis: white lashes

Multisystem disorder with auto-immune response causeing WHITENING with sun exposure.

Ocular signs: poliosis, uvietis, post inflammatory Redtinal Detachment,

other assoc: HA, encephaopathy, seizure, limmiting, vertigo, deafnes..

• Autosomal recessive,

• upon exposure to sunlight there is progressive pigmentation changes = macules (flat discolored area),

increased incidence of BCC  (basal cell carcinoma ) and SCC (squamous cell carcinoma) and melanoma as well as conjunctival malignancies.

Flesh eating bacteroa.

Swelling associated with well defined expanding red line along the lind.

px is sick , keeps geting worse, rapid effect.

Etiol: beta-hemolytic Strep. pyogenes secondary to skin trauma likd bug bite!

can lead to entrpopion or ectropion

Erythema multiforme / stevens-johnson syndrome, 

disease of the skin of the lids

SEVERE DTH (delayed type hypersensitivivity ) usually to MEDS.

young age, more in males.

Flue sx with severe rash that's patcchy-bull's eye, perivascular inflammations.

Ocular signs of Erythema multiforme/stevens-johnson syndrome, 

disease of the skin of the lids

Treatment for Erythema multiforme / stevens-johnson syndrome, 

disease of the skin of the lids

electrolytes,

stystemical topical steroids in high doses!

bandage Hard CLs( put saline and tears and cover to stya hydrated),

may require surger to decrease scaring

autoimmune mucouls membrne disorder, 90% will have giant canker sores in mouth. OLDER people,

25% to 33% will have vision loss

Ocular signs of ocular cicatrical pemphigoid,

disease of the skin of the lids

Treatment for ocular cicatricial pemphigoid

Supportive:

tears, SOFT, SCLERAL bandage lens,  epilation (pluck lashes),

tarsorraphy (stick lids shut),

plugs (punctual occlusion),

Immunosupression with restasis, steroids, cylophosphamide

• common staph infxn (usually strep)

MACULAR (flat distinct, colored) rash on lids and face with bullae which cruts over. common in children (yellow rash)

 frontal nerve most freq: pper lid, forehead, superior conj.

Young px; think HIV

< 50 yo think immuno supression

HA fever, malaise, chills, deep pain, hyper esthesia,edima, vesicels on one side, can leave scarring and persitent pain,

• scarring can lead to retraction,

• ptosis,

• ectropion,
• madorosis (loss of lashes)

• entropion

Ophthalmic branch of CN V is affected

Lots of tiny cold sores, 20% of ocular involves lids only,

vesicles -->

rupture-->

crust-->

heal.

Ocular signs: lid edema, follicular response (small body or sac)

lasts 10-14 days.

1. Analgesics,
2. prednisone,
3. antidepressants,
4. oral antivirals(ACV),
5. Topicals: drying lotions like calamine lotion, sterods, antihistamines

want it to stay on lids and not go to the cornea:

• Prophylaxis to prevent corneal involvement,

Acyclovir creme,

GCV gel (zirgan)

• Antibiotics to prevent secondary bacterial infxn

• drying agents

• oral antivirals if multiple recurrences.