Impact and Management of Loss of Eyebrows and Eyelashes.

Eyelashes and eyebrows have different functions, ranging from practical purposes such as protecting the eye apparatus from external hazards to the definition of our facial expression. For this reason, their loss could have both functional and psychological impact on patients' quality of life. Complete or partial loss can occur any time during life, and identifying the cause is mandatory to establish a correct and prompt treatment. The aim of this paper is to create a practical guide for the management of the most common causes of madarosis to the best of our knowledge.

Eyelash loss in frontal fibrosing alopecia: Microscopic features of two cases.

BACKGROUND: To report two cases of eyelash loss in Frontal Fibrosing Alopecia, providing microscopic description of the eyelashes and possible association with Demodex folliculorum. CASE PRESENTATION: We present two cases of postmenopausal women diagnosed with frontal fibrosing alopecia who consulted the ophthalmology department for eyelid itching and eyelash loss. On examination, there were no signs of blepharitis, but loss of lashes was observed, and the remaining eyelashes detached easily from the eyelid. The eyelashes were examined microscopically. The bulbs were small and narrow, and the caliber of the lashes was irregular, with thinner and thicker areas. The pigment distribution was irregular; there were portions with greater or lesser accumulation. In the second case, clusters of Demodex folliculorum were observed near the eyelash root. CONCLUSION: This is the first microscopic description of eyelash loss in frontal fibrosing alopecia in the published literature. We describe small, narrow bulbs, irregular caliber of the eyelashes and irregular pigment distribution. In the second case, in which we found Demodex folliculorum infestation, there was eyelash loss even though the disease was not very advanced. We suggest that there might be an association whereby Demodex infestation might accelerate autoimmune inflammation, leading to premature eyelash loss.

Bilateral upper and lower eyelid margin swelling and madarosis due to lymphoma.

Over a 2-year period, swellings of all 4 eyelid margins developed in a 32-year-old woman and was accompanied by complete loss of eyelashes. An inflammatory dermatologic condition was considered the most likely cause. A full-thickness right lower eyelid biopsy revealed a multinodular lymphoid tumor at the eyelid margin which immunophenotypically and genetically was diagnosed as an extranodal marginal zone lymphoma. The mode of presentation of the disease was considered to be most unusual, as was its B cell lineage, since the majority of primary cutaneous lymphomas are of T-cell origin. Systemic workup demonstrated bilateral involvement of the external auditory canals.

Madarosis: a marker of many maladies.

Madarosis is a terminology that refers to loss of eyebrows or eyelashes. This clinical sign occurs in various diseases ranging from local dermatological disorders to complex systemic diseases. Madarosis can be scarring or non-scarring depending upon the etiology. Appropriate diagnosis is essential for management. Follicular unit transplantation has been found to be a useful method of treating scarring madarosis and the procedure relevant to eyebrow and eyelash reconstruction has been discussed. A useful clinical approach to madarosis has also been included for bedside diagnosis. The literature search was conducted with Pubmed, Medline, and Google scholar using the keywords madarosis, eyebrow loss, and eyelash loss for articles from 1960 to September 2011. Relevant material was also searched in textbooks and used wherever appropriate.