What is the infraorbital fold skin manifestation in a patient with atopic dermatitis (atopic dermatitis), specifically referring to Dennie-Morgan lines, Keratoconus, Keratosis pilaris, or Pityriasis alba?

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Last updated: May 22, 2025View editorial policy

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From the Guidelines

The answer is a. Dennie-Morgan lines, which are symmetrical, prominent folds extending from the medial aspect of the lower lid and are often noted in patients with atopic dermatitis, as described in the study by 1. These lines are thought to result from chronic inflammation and edema in the periorbital region and are usually present at birth or appear shortly thereafter, persisting for life. Some key characteristics of Dennie-Morgan lines include:

  • They are symmetrical and prominent folds
  • They extend from the medial aspect of the lower lid
  • They are often noted in patients with atopic dermatitis, as seen in 60% to 80% of atopic children
  • They may have an ethnic variation and are characteristically but not exclusively present in patients with allergy Unlike the other options, Dennie-Morgan lines specifically affect the infraorbital area. Other options, such as:
  • Keratoconus, which is an eye condition causing thinning of the cornea
  • Keratosis pilaris, which presents as small rough bumps typically on the upper arms and thighs
  • Pityriasis alba, which manifests as hypopigmented patches usually on the face and upper extremities, do not represent infraorbital fold skin manifestations in patients with atopic dermatitis, as described in the study by 1. Recognizing Dennie-Morgan lines can help clinicians identify atopic dermatitis, especially in patients with other characteristic features of the condition, and provide appropriate management and treatment, as outlined in the study by 1.

From the Research

Infraorbital Fold Skin Manifestation in Atopic Dermatitis

  • The infraorbital fold skin manifestation in a patient with atopic dermatitis is referred to as Dennie-Morgan lines 2, 3.
  • Dennie-Morgan lines are characterized by a fold of skin under the eye, which is a common feature in patients with atopic dermatitis, particularly those with lower eyelid dermatitis 2.
  • The presence of Dennie-Morgan lines can be an important diagnostic criterion for atopic dermatitis, especially in children 3.
  • Other options, such as Keratoconus, Keratosis pilaris, and Pityriasis alba, are not directly related to the infraorbital fold skin manifestation in atopic dermatitis 4, 5, 6.

Relevant Studies

  • A study published in 1981 found that an infraorbital fold (Dennie-Morgan fold) occurred in 25% of patients with atopic dermatitis 2.
  • A more recent study published in 2023 highlighted the importance of Dennie-Morgan folds as a diagnostic criterion for atopic dermatitis in children, with a prevalence of 71.8% in a study population 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Infraorbital fold in atopic dermatitis.

Archives of dermatology, 1981

Research

Atopic Dermatitis: Diagnosis and Treatment.

American family physician, 2020

Research

Topical Corticosteroids: Choice and Application.

American family physician, 2021

Research

Prescriptions for atopic dermatitis: oral corticosteroids remain commonplace.

The Journal of dermatological treatment, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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