A Dennie–Morgan fold, also known as a Dennie–Morgan line or an infraorbital fold, is a fold or line in the skin below the lower eyelid. It can simply be an ethnic/genetic trait,[3] but was found in one study to occur in 25% of patients with atopic dermatitis.[4] The presence of Dennie–Morgan folds can be used as a diagnostic marker for allergy,[5][6] with a sensitivity of 78% and specificity of 76% for atopic dermatitis according to one study,[7] although another study found them to be of diagnostic significance in atopic dermatitis.[8] The condition was described by Charles Clayton Dennie and David B. Morgan in 1948. [9][10]
The pathophysiology of this sign is not clear. One proposed mechanism is that continuous spasm of the superior tarsal muscle and skin edema could be due to hypoxia from poor circulation.[4]
A Dennie–Morgan fold should not be confused with an "allergic shiner", which is a purple-gray discoloration with associated fullness beneath the lower eyelid. This is related to the accumulation of blood and other fluid in the infraorbital groove resulting from nasal congestion.[4]
^CTMA 2019: Compendium of therapeutics for minor ailments (2018). Ottawa, Ontario: Canadian Pharmacists Association.
^Yen, Angela; Sanchez, Ramon; Oblender, Melanie; Raimer, Sharon (February 1996). "Leukemia cutis: Darier's sign in a neonate with acute lymphoblastic leukemia". Journal of the American Academy of Dermatology. 34 (2): 375–378. doi:10.1016/S0190-9622(07)80012-0. PMID8655730.
^ abcBlanc S, Bourrier T, Albertini M, Chiaverini C, Giovannini-Chami L (June 2015). "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. PMID25890677.
^Schram ME, Leeflang MM, DEN Ottolander JP, Spuls PI, Bos JD (September 2011). "Validation and refinement of the Millennium Criteria for atopic dermatitis". The Journal of Dermatology. 38 (9): 850–8. doi:10.1111/j.1346-8138.2011.01202.x. PMID21453318. S2CID26399856.
^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. PMID3234581.