Eyelash Poliosis

• Idiopathic- diagnosis of exclusion
• Vitiligo
  • acquired pigmentary disorder of skin and hair with depigmented skin patches
  • frequently associated with other autoimmune conditions.
• Chronic blepharitis
• Post-inflammatory change from atopic or contact dermatitis especially if there is a history of eczema or dermatitis involving the periocular region.
• Drug-induced
  • topical prostaglandin F(2α) analogues used for glaucoma, usually reversible poliosis
• Skin lesions
  • Cutaneous/ocular malignant melanoma may rarely present with poliosis due to destruction of melanocytes adjacent to a melanoma; biopsy is required for diagnosis
  • Halo nevus or other benign nevus-associated poliosis
    • localized whitening of lashes adjacent to a melanocytic nevus.
• Uveitis associated poliosis
  • Phthisis bulbi
  • Vogt–Koyanagi–Harada (VKH) disease
    • a multisystem autoimmune disorder
    • bilateral granulomatous uveitis, auditory symptoms, and meningeal signs.
  • Sympathetic ophthalmia is a bilateral granulomatous uveitis

1. Vitiligo: A Comprehensive Overview Part I. Introduction, Epidemiology, Quality of Life, Diagnosis, Differential Diagnosis, Associations, Histopathology, Etiology, and Work-Up. Alikhan A, Felsten LM, Daly M, Petronic-Rosic V.Journal of the American Academy of Dermatology. 2011;65(3):473-491.
2. Atopic Dermatitis.Ständer S. The New England Journal of Medicine. 2021;384(12):1136-1143. doi:10.1056/NEJMra2023911.
3. Topical Prostaglandin F(2alpha) Analog Induced Poliosis. Chen CS, Wells J, Craig JE. American Journal of Ophthalmology. 2004;137(5):965-6. doi:10.1016/j.ajo.2003.11.020.
4. Poliosis Circumscripta: Overview and Underlying Causes. Sleiman R, Kurban M, Succaria F, Abbas O. Journal of the American Academy of Dermatology. 2013;69(4):625-33. doi:10.1016/j.jaad.2013.05.022.
5. Precise, Simplified Diagnostic Criteria and Optimised Management of Initial-Onset Vogt-Koyanagi-Harada Disease: An Updated Review. Herbort CP, Tugal-Tutkun I, Abu-El-Asrar A, et al. Eye (London, England). 2022;36(1):29-43. doi:10.1038/s41433-021-01573-3.

Recent Advances in Diagnosis and Management of Sympathetic Ophthalmia. Fromal OV, Swaminathan V, Soares RR, Ho AC.

Current Opinion in Ophthalmology. 2021;32(6):555-560. doi:10.1097/ICU.0000000000000803.

8. Guidelines of Care for the Management of Primary Cutaneous Melanoma. Swetter SM, Tsao H, Bichakjian CK, et al.

Journal of the American Academy of Dermatology. 2019;80(1):208-250. doi:10.1016/j.jaad.2018.08.055.

Practice Guideline