Dennie–Morgan fold

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Dennie–Morgan fold below the lower eyelid

A Dennie–Morgan fold, also known as a Dennie–Morgan line or an infraorbital fold and sometimes as the Allergic Salute and the Dennie's Sign, is a fold or line in the skin below the lower eyelid caused by edema in atopic dermatitis. The presence of Dennie–Morgan folds is used as a diagnostic marker for allergy with a sensitivity of 78% and specificity of 76%.[1][2][3][4]

The pathophysiology of this sign is not clear. One proposed mechanism is that continuous spasm of the Muller eyelid muscle and skin edema could be due to hypoxia from poor circulation.[5]

Dennie–Morgan fold should not be confused with allergic shiners or dark circles which are purple-gray discolouration beneath the lower eyelid. This is related to the accumulation of blood and other fluid in the infraorbital groove resulting from nasal congestion. Allergic shiner is less sensitive than Dennie–Morgan fold.[5]

See also[edit]

References[edit]

  1. ^ Schram, Mandy E.; Leeflang, Mariska M. G.; DEN Ottolander, Jan Paul S.; Spuls, Phyllis I.; Bos, Jan D. (2011-09-01). "Validation and refinement of the Millennium Criteria for atopic dermatitis". The Journal of Dermatology. 38 (9): 850–858. doi:10.1111/j.1346-8138.2011.01202.x. ISSN 1346-8138. PMID 21453318. 
  2. ^ Morgan DB (June 1948). "A suggestive sign of allergy". Arch Dermatol Syphilol. 57 (6): 1050. doi:10.1001/archderm.1948.01520190129018. PMID 18098747. 
  3. ^ Uehara M (October 1981). "Infraorbital fold in atopic dermatitis". Arch Dermatol. 117 (10): 627–9. doi:10.1001/archderm.1981.01650100029022. PMID 7283456. 
  4. ^ Mevorah B, Frenk E, Wietlisbach V, Carrel CF (1988). "Minor clinical features of atopic dermatitis. Evaluation of their diagnostic significance". Dermatologica. 177 (6): 360–4. doi:10.1159/000248607. PMID 3234581. 
  5. ^ a b Blanc, Sibylle; Bourrier, Thierry; Albertini, Marc; Chiaverini, Christine; Giovannini-Chami, Lisa. "Dennie-Morgan Fold Plus Dark Circles: Suspect Atopy at First Sight". The Journal of Pediatrics. 166 (6): 1541. doi:10.1016/j.jpeds.2015.03.033. PMID 25890677.