University of Wisconsin–Madison Medical College of Wisconsin

Periorbital Dermatitis Induced by Apixaban

Kelsey Koenig, MD; Grace Tews, BA; Aleksander Downs, MD

WMJ. 2025;123(1):e1-e2. Published early online March 10, 2025.

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ABSTRACT

Introduction: Periorbital dermatitis can be due rarely to an adverse drug reaction. We present a case of a patient whose periorbital dermatitis was caused by apixaban.

Case Presentation: A 76-year-old female presented with severe periorbital dermatitis 3 weeks after starting apixaban. Varying potencies of antihistamines, topical steroids, calcineurin inhibitors, and emollients were used over a 20-month span with no relief of symptoms. Upon discontinuing apixaban and switching to rivaroxaban, she experienced complete resolution of her symptoms.

Discussion: Periorbital dermatitis is a lesser-known adverse effect of apixaban. To our knowledge, there has only been 1 other reported case of periorbital dermatitis induced by apixaban.

Conclusions: We report this case to increase awareness among clinicians of adverse effects of apixaban and to encourage consideration of drug side effects as part of the differential diagnosis for new skin complaints.


Author Affiliations: Waukesha Family Medicine Residency at Prohealth, Waukesha, Wisconsin (Koenig, Downs); Medical College of Wisconsin, Milwaukee, Wisconsin (Tews).
Corresponding Author: Kelsey Koenig, MD, Waukesha Family Medicine Residency at Prohealth – Assistant Director, Waukesha, WI 53188; email kelsey.koenig@phci.org.
Funding/Support: None declared.
Financial Disclosures: None declared.
Acknowledgements: This patient gave signed written consent for publication of her photo.
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