Patel Plastic Surgery Salt Lake City and St. George
  • Home
  • Locations
    • Plastic Surgery Salt Lake City
    • Plastic Surgery St. George
  • Conditions
    • Aging Of The Face
    • Aging of Lower Eyelids
    • Aging of the Forehead and Brows
    • Aging of Upper Eyelids
    • Aging of the Cheeks
    • Aging of the Neck
    • Aging of the Lips
    • Aging of the Mouth
    • Aging of the Chin
    • Aging of Eyelashes
    • Aging of the Hands
    • Aging Of Skin Colour
    • Aging Of Hair
    • Aging of the Jowls
    • Aging of Men
    • Aging of the Skin
    • Aging of Veins and Vessels
    • Scars
  • Cosmetic
    • Facelift
    • Browlifts
    • Lower Blepharoplasty
    • Upper Blepharoplasty
    • Midface Lift/Hammock Lift
    • Necklift
    • Cosmetic Surgery for Men
    • Lip Lines
    • Lips
    • Mouth
    • Neck Liposuction
    • Fat Transfer
    • Skin Resurfacing
    • Cheeks
    • J-PLASMA SKIN RESURFACING
    • J-PLAZTY FACE
    • Removal of Moles, Lesions, Tags, Cysts and Blemishes
    • Facial Implants
    • Otoplasty, Ear Pinning, or Bat-Ear Repair
    • Complications?
  • Reconstruction
    • Acquired Ptosis and Dermatochalasis
    • Congenital Ptosis
    • Ptosis in Myasthenia Gravis
    • Blepharophimosis Syndrome
    • Entropion
    • Ectropion
    • Thyroid Eye Disease
    • Nasolacrimal Duct Obstruction
    • Skin Tumors
    • Orbital Tumors
    • Blepharospasm
    • Pterygium
    • Anophthalmos and Microphthalmos
    • Enucleation and Evisceration
    • Exenteration
    • Symblepharon
    • Congenital Anomalies - Lid Disorders
    • Acne Rosacea
    • Trauma
    • Infections
  • Non Invasive
    • Photorejuvenation
    • Aerolase Laser
    • Botox
    • Radiesse
    • Restylane
    • Juvederm
    • Fractional Carbon Dioxide CO2 Laser
    • Fractional Resurfacing Lasers: Erbium lasers
    • Laser Hair Removal
    • Kybella
    • Chemical Peels
    • XEOMIN ®
    • Voluma
    • LATISSE EYELASH TREATMENT
    • Leg Veins and Spider Vein Treatment
    • Sculptra
    • Neck and Chest Cosmetic Concerns
    • Dysport
    • Accent Radiofrequency
    • Microdermabrasion and Light Chemical Peels
    • Melasma
    • Laser Tattoo Removal
    • Color and Texture Issues – Brown Spots on Face, Redness
    • Scars and Acne
    • Permanent Cosmetic Makeup
  • Resources
    • Patient Forms & Downloads
    • Out Of State and Overseas Patients
    • Reviews
    • VIDEOS Patel Plastic Surgery
  • About
  • Blog
  • Contact

Articles

What are Dennie-Morgan lines and how do you treat them?

2 Comments

 
Picture

definition of dennie-morgan lines

One or more creases along the lower eyelid that start at the medial canthus and progress outwards and slightly further down from the eyelid margin. There may be one or more of such lines and when they are occur in the presence of atopic dermatitis, they are called Dennie-Morgan lines. 

At what age are dennie-morgan lines seen?

Dennie-Morgan lines are usually seen in children when they develop atopic dermatitis and can be seen soon after birth. Dr Charles C. Dennie used to teach that these lines are usually retained throughout life. They become more prominent when patients have active atopic dermatitis. 
Dennie-Morgan lines in a child and in an adult BCK Patel MDPicture
Photographs from the original 1948 paper in the Archives of Dermatology and Syphilology by Dr. David B Morgan showing the Dennie-Morgan lines in a young child and in an adult, both with atopic dermatitis

What are dennie-morgan lines associated with?

Dennie-Morgan lines are seen in patients with atopic dermatitis which may present as eczema, allergic rhinitis or chronic sinusitis. The lines are often associated with lower eyelid skin thickening due to chronic oedema. They are also often associated with "allergic shiners" which are dark circles under the eyes which are caused by venous stasis. "Allergic shiners" are seen in about 60% of atopic patients. 
Dennie-Morgan lines present together with
Dennie-Morgan lines present together with an "allergic shiner" which is the dark circle affecting the lower eyelid caused by venous stasis and chronic inflammation with hyperpigmentation and thickening of the skin

why are these lines called "dennie-morgan" lines?

Dr Charles Clayton Dennie (1883 - 1971) was a prominent dermatologist who practiced in Kansas City, Mo. He was an accomplished raconteur, who was popularly known as "Uncle Charlie" to sudents and colleagues alike. His special interest was congenital syphilis about which he published extensively. He used to teach his students that the lines one sees below the eyelids were typically seen in patients with atopic dermatitis. Although he never published this himself, one of his colleagues, Dr. David B. Morgan (1911 - 2001), also a Kansas City dermatologist, published this teaching in a brief report in 1948, entitled "A suggestive sign of Allergy" and explained that this was the teaching of Dr. Charles C. Dennie. Thereafter, these lines have been called either "Dennie lines", or "Dennie-Morgan lines or folds".
Photograph of Dr. Charles C. Dennie of Kansas City. Dr. BCK Patel Md, FRCSPicture
Charles Clayton Dennie photographed in his office at the Kansas University School of Medicine where he served as head of dermatology from 1939 - 1949

Other contributions of Charles C Dennie

Dennie's Solution used for the treatment of keratoses
Dennie-Morgan lines
Dennie-Mafan syndrome:
spastic paraplegia of the lower limbs and mental retardation in children with congenital syphilis which he described in 1929. The same syndrome was described by the French doctor, Antoine Marfan in 1936 and is therefore known as the Dennie-Marfan syndrome.
Syphilis acquired and heredosyphilis published in 1928
A History of Syphilis published in 1962

A history of Syphilis by Charles Clayton Dennie published in 1962 Dr. BCK Patel MD, FRCSPicture
A history of Syphilis by Charles Clayton Dennie published in 1962

How are Dennie-Morgan lines different from normal aging lines?

Dennie-Morgan lines with surrounding thickening of the skin, edema and discoloration in a young adult Dr. BCK Patel MD, FRCS
Dennie-Morgan lines with surrounding thickening of the skin, edema and discoloration in a young adult
Chronic allergic changes or eczema result in collagen breakdown secondary to inflammation and chronic irritation, resulting in localized edema and folds or grooves. These are different from the normal aging changes which produce lower eyelid wrinkles, usually after mid-30s. Patients who have flare-ups into adulthood will have the thickening and folds and grooves affecting the lower eyelids as adults. These patients have skin that is sensitive and will be easily irritated and react to external chemicals. 
Dennie Morgan lines in an adult together with thickening of the surrounding skin and darkening of the skin by chronic inflammation and venous stasis Dr BCK Patel MD, FRCSPicture
Dennie Morgan lines in an adult together with thickening of the surrounding skin and darkening of the skin by chronic inflammation and venous stasis

How do you treat Dennie-Morgan lines in adults?

Treatment of the underlying atopic dermatitis is vital. As the skin is sensitive to many products, dermatologists will order patch testing to determine the products that should be avoided. The aim is to reduce the inflammation and the irritation. It is best to avoid all products when the inflammation is active. Most dermatologists suggest the use of emollients like CeraVe moisterizing cream. Ceramides are often incorporated in such moisterizers and help to replenish the lack of the natural ceramides (oils) that our skin produces normally. The second important component is hyaluronic acid (HA), which also occurs naturally in human skin cells. HA hydrates and plumps skin. The addition of ceramides and HA allows the skin to "plump" and hydrate. CeraVe does not contain paraffins, parabens and oils. 

It is best to avoid all makeup and other lotions and potions when the dermatitis is active. Even ingredients that one is not allergic to can cause an increase in the inflammation because of the defective skin barrier in the presence of inflammation. We always take the "cold turkey" approach by stopping all topical creams, lotions and ointments and only introducing emollients gradually. 

​Vaseline and Aquaphor are also useful as they allow retention of hydration. Aveeno parabens lotion and cetaphil lotion are also hypoallergenic and useful for atopic dermatitis. Eucerin Urea Repair Rich Replenishing face cream is is also useful for dry, scaly skin.    

A weak topical anti-inflammatory like a weak steroid like Desonide or Desowen 0.05% cream may be needed to reduce the inflammation. 
Dennie-Morgan lines in adolescence with skin thickening and parallel creases and folds dr BCK Patel MDPicture
Dennie-Morgan lines in adolescence with skin thickening and parallel creases and folds

What can be done to my wrinkles once the inflammation causing the Dennie-Morgan lines is controlled?

A number of treatments may help improve the texture and tone of the skin with the use of chemical peels, fractionated resurfacing lasers, and hyaluronic acid fillers. It is important to ensure that the inflammation is controlled before instituting these treatments. For finer lines laterally, botulinum toxin (Botox, Dysport, etc) can be useful. 
​
2 Comments

When should I start getting botox and can it be used for preventive purposes? Here are the answers to when it works and how it is used in Salt Lake City and St. George by Dr. BCK Patel MD, FRCS

0 Comments

 
Botox injections to frown muscles, forehead lines and brows by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George
Nice improvement in the severe frown lines ("elevenses") and also in the height of the brows with botox in a patient in her late 40s. Notice the improvement in her skin with the use of lasers

Which parts of the face does botox work best on?

​Botox has become one of the most popular cosmetics treatments sought in the USA. Although the term "Botox" is widely used, the products used are varied and include Botox, Dysport, Myobloc, Xeomin, Jeuveua and others. Cosmetically, any of these products are used for one or more of the following reasons:
  • frown lines between brows ("elevenses")
  • frown line across the bridge of the nose
  • smile lines
  • forehead lines
  • crow's feet
  • bunny lines
  • raise the corner of the mouth (improve the "frowny" mouth)
  • improve the jawline (the vampire lift)
  • improve neck platysma bands
  • make subtle changes in the position of the upper and lower eyelids
  • improving the fullness caused by the masseter muscles (round face to oval face change)
​

Besides cosmetic applications, how else is botox useful?

Botox is also used for other medical conditions:
  • treating migraine
  • treating excessive sweating
  • decreasing sweating
  • treating blepharospasm and hemifacial spasm
  • treating aberrant nerve regeneration after Bell's palsy

Commonly asked questions about when to start botox and when is it too early or too late?

​Common questions we are asked are:
  • "what is the right age to start?"
  • "am I too young to start with botox?"
  • "should I have started earlier?"
  • "am I too far gone with my wrinkles to benefit from botox?"
  • "will the botox get rid of all my lines?"
  • "why do I have to keep on repeating the injections of botox?"
A more recent development is the use of Botox as a preventative measure to decrease the development of wrinkles and lines. Here are all the answers to all your questions about botox and preventative botox in Salt Lake City and St. George, Utah.

Read More
0 Comments

    Author

    Dr. BCK Patel MD, FRCS

    Categories

    All

    RSS Feed

    Archives

    August 2022
    February 2018

Conditions

Aging Of The Face
Aging of Lower Eyelids
Aging of the Forehead and Brows
Aging of Eyelashes
Aging of the Cheeks
Aging of the Neck
Aging of the Lips
Aging of the Mouth
Aging of the Chin
Aging of Eyelashes
Aging of the Hands
Aging Of Skin Colour
Aging Of Hair
​Aging of the Jowls
Aging of Men
Aging of the Skin
Aging of Veins and Vessels
Scars

Cosmetic

Facelift
Browlifts
Lower Blepharoplasty/Hammock Lift
Upper Blepharoplasty
Midface Lift/Hammock Lift
Necklift
Lips
Mouth
Neck Liposuction
Fat Transfer
Skin Resurfacing
Cheeks
J-PLASMA SKIN RESURFACING
J-PLAZTY FACE
Removal of Moles, Lesions, Tags, Cysts and Blemishes
Facial Implants
Otoplasty, Ear Pinning, or Bat-Ear Repair
​Complications?

Reconstruction

​Entropion
Acquired Ptosis
Ectropion
Congenital Ptosis
Blepharospasm
Anophthalmos and Microphthalmos
Thyroid Eye Disease
Enucleation and Evisceration
Nasolacrimal Duct Obstruction
Symblepharon
Congenital Anomalies - Lid Disorders
Acne Rosacea
Trauma
Infections
Skin Tumors
Orbital Tumors

Non- Invasive

 Photorejuvenation
Aerolase Laser
Botox
Laser Hair Removal
Kybella
Juvederm
Chemical Peels
Fractional Carbon Dioxide CO2 Laser
XEOMIN ®
Voluma
Latisse Eyelash Treatment
Leg Veins and Spider Vein Treatment
Sculptra
Neck and Chest Cosmetic Concerns
Restylane
Dysport
Accent Radiofrequency
Microdermabrasion and Light Chemical Peels
Melasma
Fractional Resurfacing Lasers: Erbium lasers
Color and Texture Issues – Brown Spots on Face, Redness
Laser Tattoo Removal
Radiesse
Acne
​Permanent Cosmetic Makeup

VIDEOS

links
​
www.hammocklift.com

WWW.PATELFACELIFT.COM

www.englishsurgeon.com

www.drbhupendrapatel.com
​
bckpatel.info

WEBOFSCIENCE

researchgate

GOOGLE SCHOLAR

Patel Plastic Surgery  .  Copyright 2022 . All Rights Reserved
  • Home
  • Locations
    • Plastic Surgery Salt Lake City
    • Plastic Surgery St. George
  • Conditions
    • Aging Of The Face
    • Aging of Lower Eyelids
    • Aging of the Forehead and Brows
    • Aging of Upper Eyelids
    • Aging of the Cheeks
    • Aging of the Neck
    • Aging of the Lips
    • Aging of the Mouth
    • Aging of the Chin
    • Aging of Eyelashes
    • Aging of the Hands
    • Aging Of Skin Colour
    • Aging Of Hair
    • Aging of the Jowls
    • Aging of Men
    • Aging of the Skin
    • Aging of Veins and Vessels
    • Scars
  • Cosmetic
    • Facelift
    • Browlifts
    • Lower Blepharoplasty
    • Upper Blepharoplasty
    • Midface Lift/Hammock Lift
    • Necklift
    • Cosmetic Surgery for Men
    • Lip Lines
    • Lips
    • Mouth
    • Neck Liposuction
    • Fat Transfer
    • Skin Resurfacing
    • Cheeks
    • J-PLASMA SKIN RESURFACING
    • J-PLAZTY FACE
    • Removal of Moles, Lesions, Tags, Cysts and Blemishes
    • Facial Implants
    • Otoplasty, Ear Pinning, or Bat-Ear Repair
    • Complications?
  • Reconstruction
    • Acquired Ptosis and Dermatochalasis
    • Congenital Ptosis
    • Ptosis in Myasthenia Gravis
    • Blepharophimosis Syndrome
    • Entropion
    • Ectropion
    • Thyroid Eye Disease
    • Nasolacrimal Duct Obstruction
    • Skin Tumors
    • Orbital Tumors
    • Blepharospasm
    • Pterygium
    • Anophthalmos and Microphthalmos
    • Enucleation and Evisceration
    • Exenteration
    • Symblepharon
    • Congenital Anomalies - Lid Disorders
    • Acne Rosacea
    • Trauma
    • Infections
  • Non Invasive
    • Photorejuvenation
    • Aerolase Laser
    • Botox
    • Radiesse
    • Restylane
    • Juvederm
    • Fractional Carbon Dioxide CO2 Laser
    • Fractional Resurfacing Lasers: Erbium lasers
    • Laser Hair Removal
    • Kybella
    • Chemical Peels
    • XEOMIN ®
    • Voluma
    • LATISSE EYELASH TREATMENT
    • Leg Veins and Spider Vein Treatment
    • Sculptra
    • Neck and Chest Cosmetic Concerns
    • Dysport
    • Accent Radiofrequency
    • Microdermabrasion and Light Chemical Peels
    • Melasma
    • Laser Tattoo Removal
    • Color and Texture Issues – Brown Spots on Face, Redness
    • Scars and Acne
    • Permanent Cosmetic Makeup
  • Resources
    • Patient Forms & Downloads
    • Out Of State and Overseas Patients
    • Reviews
    • VIDEOS Patel Plastic Surgery
  • About
  • Blog
  • Contact