Recurrent Periorbital Cellulitis: An Unusual Clinical Entity

Objectives To discuss the cause and management of recurrent periorbital cellulitis (RPOC). Study design Retrospective case series and review of literature. Materials and methods In the past 11 years, we have treated 6 patients for recurrent periorbital cellulitis (RPOC). Inclusion criteria were a minimum of 3 episodes of periorbital cellulitis (POC) within a 1-year period, with interval convalescence lasting at least 1 month. All patients were followed for at least 1 year after resolution. Results The causes of RPOC were as follows: (1) 2 patients developed RPOC attributed to environmental allergies; (2) 1 was diagnosed with underlying recurrent sinusitis resistant to medical management with resolution attained through surgery; (3) 1 patient with vesicular RPOC was diagnosed with herpetic RPOC and treated medically with antiviral therapy; (4) 1 patient had allergic contact dermatitis from cosmetic make-up use; and (5) 1 patient was suspected of malingering via repeat subcutaneous self-injection of an irritant. Conclusions Although periorbital cellulitis is a commonly encountered and treatable condition, recurrent periorbital cellulitis is rare and may be challenging to manage. In our experience, the causes of recurrence varied, but resolution was achieved by identifying the underlying cause through continuous clinical reassessment and by appropriate medical or surgical management. EBM rating: C-4