Infections and Autoimmune Disorders of the Eyelids – Difficult Differential Diagnoses and Therapeutic Challenges

Abstract

Various inflammatory diseases can occur in the eyelids. Infectious disorders – such as staphylococcal or demodex blepharitis, dermatological diseases such as seborrheic dermatitis, ocular rosacea or ocular cicatricial pemphigoid and rheumatological diseases such as dermatomyositis or sarcoidosis – are just some of these aetiologies. Clinically, these causes of blepharitis can manifest in inflammation of the eyelid margin with collarettes around the eyelash follicles, madarosis, meibomian gland dysfunction, erythema, and nodular tumour. Even if the clinical differential diagnosis between the various blepharitides is difficult, a correct diagnosis can significantly improve the prognosis. As most blepharitides are chronic in nature, regular and careful care of the eyelid margin is necessary to improve the patientʼs symptoms. Depending on the cause, local or systemic antibiotics or immunosuppressive agents can also help. If no improvement after treatment occurs, the previous diagnosis must be critically questioned so that masquerade syndromes such as sebaceous carcinoma are not overlooked.

Keywords

blepharitis - Meibomian gland dysfunction - demodex - rosacea - sebaceous carcinoma

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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