Infektionen und Autoimmunreaktionen an Augenlidern – schwierige Differenzialdiagnosen und therapeutische Herausforderungen

Zusammenfassung

An den Augenlidern können verschiedene inflammatorische Erkrankungen auftreten. Hierzu gehören infektiologische Ursachen wie die Staphylokokken- oder Demodex-Blepharitis, dermatologische Erkrankungen wie die seborrhoische Dermatitis, die okuläre Rosazea oder das okuläre Schleimhaut-Pemphigoid und auch rheumatologische Erkrankungen wie die Dermatomyositis oder die Sarkoidose. Klinisch können sich diese verschiedenen Erkrankungen in Lidrandentzündungen mit Kolaretten um die Wimpernfollikel, Wimpernausfall (Madarosis), Meibom-Drüsen-Dysfunktion und Erythemen bis hin zu nodulären Raumforderungen äußern. Auch wenn die klinische Differenzialdiagnostik zwischen den verschiedenen Blepharitiden schwierig ist, so kann eine korrekte Diagnosestellung die Prognose deutlich verbessern. Da die meisten Blepharitiden chronischer Natur sind, ist eine regelmäßige und sorgfältige Lidrandpflege notwendig, um die Beschwerden der Patienten langfristig zu lindern. Je nach Ursache können zusätzlich lokale oder systemische Antibiotika oder Immunsuppressiva helfen. Sollte sich unter einer angewandten Therapie keine Besserungstendenz zeigen, so sollte die bisherige Verdachtsdiagnose kritisch hinterfragt werden, um Maskerade-Syndrome wie das Talgdrüsenkarzinom nicht zu übersehen.

Schlüsselwörter

Blepharitis - Meibom-Drüsen-Dysfunktion - Demodex - Rosazea - Talgdrüsenkarzinom

Publication History

Received: 18 February 2025

Accepted: 20 August 2025

Accepted Manuscript online:
25 August 2025

Article published online:
12 December 2025

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