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To the Editor:—
I disagree with the explanation of "Dark Circles Under the Eyes" in The Journal (193: 411, 1965) given by Dr. R. K. Winkelmann. In several publications and scientific exhibits, I have used the term "allergic shiners" for this condition. Too often, these discolorations, particularly in children, are ascribed to chronic eyestrain, fatigue, or, in women at menarche, to menstruation. Since most of these eye shadows begin in early life, what transpires in the adult is often an extension of the process from childhood.In children this stigma is primarily caused by venous stasis as a result of perennial allergic rhinitis. Children with chronic nasal allergy develop these discolorations in the lower orbitopalpebral grooves from allergic edema of the mucous membranes of the nasal and paranasal cavities. The pressure of edematous mucous membranes on the venous network of the nasal and paranasal cavities interferes with normal drainage of
Marks MB. Dark Circles Under the Eyes. JAMA. 1965;194(6):678. doi:10.1001/jama.1965.03090190100034
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