A 24-year-old man presented with a 4-year history of idiopathic blepharoconjunctivitis. The disease, which is clinically characterized by edematous, erythematous plaques of the lower eyelids, was unresponsive to several courses of corticosteroid eye drops and systemic cyclosporine. The patient's medical history was remarkable for atopy and seborrheic dermatitis.
Clinical examination revealed conjunctival hyperemia and erythematous and desquamative dermatitis with erosions, infiltrated plaques, and loss of cilia in the outer third of the lower eyelids (Figure 1). A biopsy specimen was obtained from the cutaneous outer aspect of the eyelids (Figure 2
and Figure 3).