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Solly Elmann, Todd Shepler, Cindy Calderon, Robert M. Schwarcz, Michael Connor, John W. Shore, Sean M. Blaydon, Edward J. Wladis, Roman Shinder; Periocular Abscesses Following Brow Epilation. Invest. Ophthalmol. Vis. Sci. 2011;52(14):733.
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Preseptal cellulitis and abscess may be caused by periocular trauma. Periocular abscess following brow epilation has only been described in a single case report. We describe the presentation, radiography, culture results, and treatments in patients with periocular abscess after brow epilation.
Records of 20 patients referred for periocular abscess after brow epilation were reviewed.
20 women with a median age of 25 years (range 12-61) were referred for oculoplastic evaluation of a periocular abscess temporally related to recent brow epilation (Fig 1, 2). Diagnosis in all cases was confirmed by exam, and in some cases orbital CT imaging. All patients were treated with incision and drainage along with systemic antibiotics. 10 cases had culture proven MRSA, 2 had Staph Aureus, and 6 had no culture growth. All patients had resolution of their abscess at 1 month follow up visit without any cases progressing to orbital cellulitis.
Periocular abscess after brow epilation has been described in only a single case report in the literature. We believe this entity is under-reported as evidenced by our current 20 patient series, and the high prevalence of cosmetic brow epilation among females. This diagnosis should be specifically investigated through a careful history in any patient presenting with a periocular abscess or preseptal cellulitis. A high incidence of MRSA related abscesses was observed in this study, and MRSA sensitive antibiotics may be a prudent first line choice when treating such patients. The pathophysiology resulting in abscess formation after brow epilation may be due to normal flora gaining access to subcutaneous tissue through local trauma to the epidermis or skin appendages. Another potential explanation is poor epilation hygiene.
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