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Madarosis is characterised by either complete or partial loss of eyebrow or eyelash hair. Hair loss occurs due to interrupted blood supply to that region. In contemporary medicine, the management of madarosis includes hair transplant surgery or the use of steroids. There is no direct correlation to madarosis in Ayurveda; however, concepts like “Pakshmashata” described by Acharya Vagbhata exhibit symptoms that closely resemble this condition. In the present case report, a 30-year-old female patient presented to the Outpatient Department (OPD) of Kayachikitsa, complaining of sudden hair loss over the past month, accompanied by itching and a burning sensation in the affected area. A physical examination was conducted, and the patient was diagnosed with Pakshmashata. The treatment included Asthi Majja Pachak Kwath (a decoction for bone and bone marrow tissues), along with Manjistha (Rubia cordifolia) and Haridra (Curcuma longa), as well as a local paste (lepa). Jaloka Avcharan (leech therapy) was administered to the patient twice a month. For local application, Snehana (oil massage) with Eranda (Ricinus communis), taila was used three times a day. Significant improvement in hair growth in the affected area was observed during follow-ups on the 45th and 60th days.

Madarosis is characterised by either complete or partial loss of eyebrow or eyelash hair. Hair loss occurs due to interrupted blood supply to that region. In contemporary medicine, the management of madarosis includes hair transplant surgery or the use of steroids. There is no direct correlation to madarosis in Ayurveda; however, concepts like "Pakshmashata" described by Acharya Vagbhata exhibit symptoms that closely resemble this condition. In the present case report, a 30-year-old female patient presented to the Outpatient Department (OPD) of Kayachikitsa, complaining of sudden hair loss over the past month, accompanied by itching and a burning sensation in the affected area. A physical examination was conducted, and the patient was diagnosed with Pakshmashata. The treatment included Asthi Majja Pachak Kwath (a decoction for bone and bone marrow tissues), along with Manjistha (Rubia cordifolia) and Haridra (Curcuma longa), as well as a local paste (lepa). Jaloka Avcharan (leech therapy) was administered to the patient twice a month. For local application, Snehana (oil massage) with Eranda (Ricinus communis), taila was used three times a day. Significant improvement in hair growth in the affected area was observed during follow-ups on the 45th and 60th days. [ABSTRACT FROM AUTHOR]

Abstract 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.

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. [ABSTRACT FROM AUTHOR]

ObjectiveWe describe the case of a patient with metastatic breast cancer who presented with eyelid margin thickening and madarosis more suggestive of sebaceous cell carcinoma than metastatic disease. Histopathology confirmed metastatic breast adenocarcinoma.Case reportA 59-year-old woman with a known history of metastatic breast carcinoma actively enrolled in a clinical trial presented with a thickened right upper eyelid margin with madarosis and without ulceration. Although the possibility of metastasis was considered, a biopsy was performed to ensure the patient did not have a primary eyelid malignancy such as sebaceous cell carcinoma given her immunocompromised state. Histopathology revealed metastatic breast adenocarcinoma.ConclusionsTo the authors' best knowledge, metastatic breast carcinoma presenting as eyelid margin thickening without ulceration has not previously been reported. Eyelid metastasis is rare, and this patient's clinical presentation was found to be unusual as well. It is important to establish metastatic disease even in a small focus such as the eyelid, as it may alter disease management.

Xanthelasma palpebrarum (XP) is the most common cutaneous xanthoma. It is triggered by hyperlipidemia, thyroid dysfunction, and diabetes mellitus. Madarosis, loss of eyebrows, occurs in various diseases ranging from local dermatological disorders to complex systemic diseases. Herein, we present a case of giant XP in a middle-aged female in whom bilateral partial madarosis developed. In polarized contact dermoscopy, the number of hairs on xanthoma plaque was reduced compared to normal.

Background: Eyebrow loss (madarosis) is a frequent sign of frontal fibrosing alopecia (FFA), and it can be the first sign of the disease.Objective: To describe trichoscopy findings of FFA on the eyebrows.Methods: The analysis included 151 women with histologically proven diagnosis of FFA and eyebrow loss. Trichoscopy of the eyebrow area was performed with either a FotoFinder videodermatoscope or handheld dermoscope DermLite II pro.Results: The most frequent signs on trichoscopy were yellow dots (92.7%), multiple pinpoint dots (79.5%), short thin hairs/vellus (76.2%), black dots (66.2%), and dystrophic hairs (60.9%). Tapering hairs were found in 21 (13.9%) patients and dystrophic hairs in 92 (60.9%) patients.Limitations: Inner limitations of a case series (there was no comparison with healthy control individuals or patients with other hair disorders) and lack of histologic correlation to the trichoscopy findings.Conclusions: Although FFA is a scarring alopecia, the most common trichoscopy signs found in the eyebrows are usually related to noncicatricial alopecia. Therefore, in most cases, trichoscopy of the eyebrows does not resemble the trichoscopy of FFA on the scalp. Black dots, dystrophic hairs, and broken hairs are frequent signs. Occasionally, tapered hairs can be present on the eyebrows in FFA, leading to misdiagnosis of alopecia areata. [ABSTRACT FROM AUTHOR]

Background: Retinoblastoma is the most common intraocular tumor in the pediatric population. Its main therapeutic objectives are to avoid fatal outcomes and preserve vision as much as possible. Intra-arterial chemotherapy (IAC) improves drug delivery and reduces possible systemic adverse effects. This modality allows direct administration of chemotherapeutic agents to intraocular malignancies via the ophthalmic artery (OA), proving to be a feasible and effective method for globe salvage. Most side effects of IAC are local, including eyelash loss of the nasal portion of the eyelid., Summary: We performed a comprehensive review to analyze data regarding ciliary madarosis in patients diagnosed with retinoblastoma treated with IAC. We describe 9 studies with a total of 637 eyes with retinoblastoma that underwent IAC, of which 45 cases presented madarosis. In chemotherapy-induced alopecia, there is hair shaft thinning and breakage. On trichoscopy, the remaining end of the fractured hair will be observed as black dots. Differential diagnoses must include alopecia areata and trichotillomania., Key Messages: Ciliary madarosis secondary to IAC, although transitional, may cause discomfort in patients and family members. Physical examination, as well as a trichoscopic evaluation of the affected area, can help in reaching a prompt diagnosis and prognosis for this particular alopecia., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 S. Karger AG, Basel.)

Corneal hypoesthesia, Hansen's disease, Iris pearls, Lagophthalmos, Madarosis Keywords: Corneal hypoesthesia; Hansen's disease; Iris pearls; Lagophthalmos; Madarosis EN Corneal hypoesthesia Hansen's disease Iris pearls Lagophthalmos Madarosis 2671 2673 3 07/15/22 20220701 NES 220701 Leprosy or Hansen's disease (HD) is a chronic granulomatous inflammatory disease caused by intracellular, rod-shaped, acid-fast bacillus, Mycobacterium leprae (ML). [Extracted from the article]

Purpose: To report a case of cicatricial ectropion and madarosis with the use of anti-epidermal growth factor receptor medication panitumumab. Observations: An 82-year-old man with metastatic colorectal cancer presented with cicatricial ectropion and madarosis after starting panitumumab, an anti-epidermal growth factor receptor medication used to treat metastatic colorectal cancer. His findings resolved several weeks after discontinuation of panitumumab and treatment with lubrication and antibiotic/steroid ointment. Conclusion: This case demonstrates the importance to consider potential medication side effects when treating periocular conditions in patients taking anti-epidermal growth factor receptor (anti-EGFR) agents.

Introduction: Eyebrows being prominent feature of the face contributes majorily for aesthetics. Eyebrow hypotrichosis means the reduction or absence of the eyebrow hair. This is associated with negative self-esteem. Minoxidil has been found to act at the level of hair follicle by direct stimulation of follicular epithelial growth, increase cutaneous blood flow, and stimulate resting hair follicles. Aim: To study the potential role of Minoxidil for the treatment of eyebrow hypotrichosis. Materials and Methods: It was a prospective interventional study comprising of 22 subjects aged 18 years or more having eyebrow hypotrichosis. These patients garded as Grade 1 or 2 hairloss on the Allergan Global Eyebrow Assessment (GEBA) scale. All the patients were advised to apply 1 mL of 2% minoxidil lotion to eyebrow twice a day for four months. Comparison of the change in global photographic score (Subject’s satisfaction) before and after Minoxidil treatment was done, also comparison of the diameter and number of eyebrow hairs/cm2 areas between pre and post-treatment done. Paired t-test was used to compare diameter and number of eyebrow before and at the end of treatment. Results: Before treatment with Minoxidil the average hair shaft diameter was 0.034±0.0057 mm and density was 17±5.03 hairs/ cm2 . After treatment this improved to 0.07±0.0045 mm and 30±7.03 hairs/cm2 , respectively. The global photographic score was -2.1±0.76 before treatment that increased to -1.3±0.89 at four weeks and reached a peak of 2.3±0.55 at 16 weeks. The incidence of adverse events was 22.72% (5/22 subjects) which included mild itching and burning. Conclusion: This study showed that 2% Minoxidil is a welltolerated and effective treatment for eyebrow hypotrichosis.

Background: Differences in growth patterns among the various parts of the eyebrow have been observed. Aims: We aimed to investigate changes in the hair density and diameter and analyze the eyebrow growth pattern of each eyebrow part (head, body, and tail) in patients with eyebrow hypotrichosis over a 24‐week course of topical treatment. Patients/Methods: A retrospective study of 48 patients who received treatment with bimatoprost 0.01% was conducted. Patient demographic data were collected; measurements of hair density and diameter in the different parts of the eyebrow were collected and statistically evaluated. Results: The tail of the eyebrow revealed the lowest baseline eyebrow density and diameter. Significant changes in eyebrow density (P =.01) and diameter (P =.01) were first detected in the tail at 4 and 16 weeks of treatment, respectively. The head and body showed a comparable growth pattern. Conclusions: This study confirms the previous observations that hair density, diameter, pattern of growth, and hair growth cycle vary according to their anatomical location within the eyebrow. A better understanding of eyebrow growth pattern could provide the precise pathomechanism of eyebrow hypotrichosis leading to a standardized treatment protocol. [ABSTRACT FROM AUTHOR]

Abstract Background Hypereosinophilic syndrome is a hematologic disorder in which the eosinophils proliferate. Oral Janus kinase inhibitors are known to be effective treating hypereosinophilic syndrome. Janus kinase inhibitors have also demonstrated efficacy in alopecia. Madarosis is a condition in which the eyelashes are missing or absent and can been seen in alopecia patients. Case presentation We present the case of a 77-year-old Asian man who was diagnosed with hypereosinophilic syndrome, refractive to all medications except ruxolitinib. He responded well. It was noted unexpectedly that his eyelashes grew much longer than they were normally. Conclusions Previous studies have demonstrated an improvement in alopecia areata, with increased hair growth on the head and eyebrows. This study demonstrates that longer eyelashes may be another effect of oral Janus kinase inhibitors. We report the first case of eyelash elongation and thickening in a patient taking ruxolitinib. Physicians and patients should be aware of the side effect of these Janus kinase inhibitors. Further investigation is needed to ascertain whether ruxolitinib or other interleukin inhibitors can aid in the treatment of madarosis.

Objective: We describe the case of a patient with metastatic breast cancer who presented with eyelid margin thickening and madarosis more suggestive of sebaceous cell carcinoma than metastatic disease. Histopathology confirmed metastatic breast adenocarcinoma. Case Report: A 59-year-old woman with a known history of metastatic breast carcinoma actively enrolled in a clinical trial presented with a thickened right upper eyelid margin with madarosis and without ulceration. Although the possibility of metastasis was considered, a biopsy was performed to ensure the patient did not have a primary eyelid malignancy such as sebaceous cell carcinoma given her immunocompromised state. Histopathology revealed metastatic breast adenocarcinoma. Conclusions: To the authors’ best knowledge, metastatic breast carcinoma presenting as eyelid margin thickening without ulceration has not previously been reported. Eyelid metastasis is rare, and this patient’s clinical presentation was found to be unusual as well. It is important to establish metastatic disease even in a small focus such as the eyelid, as it may alter disease management.

Olmsted syndrome (OS) is a rare congenital, mutilating palmoplantar keratoderma first described by Olmsted in 1927. It starts in the neonatal period or in childhood, and has a slow but progressive disabling course. We report the case of a 16-year-old boy who presented with keratoderma of the palm and soles since childhood with lateral supraciliary madarosis and clubbing. The patient was started on oral retinoids and topical keratolytics and had partial improvement in 2 months. Keratoderma of the palms and soles along with lateral supraciliary madarosis and clubbing in our case is a very rare finding, and to the best of our knowledge, has not been reported so far.

Introduction: Eyebrows being prominent feature of the face contributes majorily for aesthetics. Eyebrow hypotrichosis means the reduction or absence of the eyebrow hair. This is associated with negative self-esteem. Minoxidil has been found to act at the level of hair follicle by direct stimulation of follicular epithelial growth, increase cutaneous blood flow, and stimulate resting hair follicles. Aim: To study the potential role of Minoxidil for the treatment of eyebrow hypotrichosis. Materials and Methods: It was a prospective interventional study comprising of 22 subjects aged 18 years or more having eyebrow hypotrichosis. These patients garded as Grade 1 or 2 hairloss on the Allergan Global Eyebrow Assessment (GEBA) scale. All the patients were advised to apply 1 mL of 2% minoxidil lotion to eyebrow twice a day for four months. Comparison of the change in global photographic score (Subject's satisfaction) before and after Minoxidil treatment was done, also comparison of the diameter and number of eyebrow hairs/cm2 areas between pre and post-treatment done. Paired t-test was used to compare diameter and number of eyebrow before and at the end of treatment. Results: Before treatment with Minoxidil the average hair shaft diameter was 0.034±0.0057 mm and density was 17±5.03 hairs/cm². After treatment this improved to 0.07±0.0045 mm and 30±7.03 hairs/cm2, respectively. The global photographic score was -2.1±0.76 before treatment that increased to -1.3±0.89 at four weeks and reached a peak of 2.3±0.55 at 16 weeks. The incidence of adverse events was 22.72% (5/22 subjects) which included mild itching and burning. Conclusion: This study showed that 2% Minoxidil is a welltolerated and effective treatment for eyebrow hypotrichosis. [ABSTRACT FROM AUTHOR]

Introduction: Ocular involvement due to varicella-zoster virus (VZV) infection includes conjunctivitis, scleritis, keratitis, uveitis, and necrotizing retinitis. Non-necrotizing chorioretinopathy as a late manifestation has been described., Case Report: A 50-year-old immunocompetent man developed herpes zoster ophthalmicus (HZO) in the right V1 dermatome with acute anterior uveitis (AAU) treated with oral valaciclovir and topical steroid and a chalazion in the upper eyelid with associated madarosis. Four months later, he presented recurrence of the AAU and multiple areas of chorioretinal atrophy on fundoscopy. Biopsy of the upper eyelid lesion revealed granulomatous inflammation of the eyelid margin and polymerase chain reaction study (PCR) tested positive for VZV-specific DNA. The iridocyclitis was resolved with oral valaciclovir at maximum doses with minimal choroidal pigmentary changes., Discussion: VZV ophthalmic infection starts by reactivation from the trigeminal ganglion, and it spreads to the isthmus of the pilosebaceous follicles and the epidermis, which can cause involvement of follicle and sebaceous glands. Chorioretinopathy is a rare form of late-onset non-necrotizing herpetic uveitis characterized by atrophic-appearing hypopigmented lesions, the pathogenesis of which is unknown. A direct viral infection or secondary to occlusive choroidal vasculitis is postulated at the level of the choriocapillaris and more recently it has been referred to as "choroidal vitiligo" due to possible involvement of choroidal melanocytes, as occurs in cases of cutaneous vitiligo due to VZV infection.

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. [ABSTRACT FROM AUTHOR]

Purpose: Eyebrow and eyelash loss (madarosis) is a common and distressing side effect of chemotherapy for which no protective strategies have yet been developed. The purpose of this study was to develop an overview of perceptions and experiences of women undergoing taxane-based treatment for early breast cancer.Methods: A total of 25 women with a diagnosis of invasive early breast cancer participated in a focus group (n = 5), ages ranging from 35 to 64 (median 50), all had completed therapy with a taxane-based chemotherapy treatment. This focus group used targeted questions to explore participants' perceptions and experience of madarosis during and following chemotherapy and identified issues associated with impact of madarosis on quality of life (QoL). Thematic analysis was conducted to identify important issues experienced by participants.Results: Seven themes emerged from the data: (1) timing of regrowth and permanent changes, (2) meaning/importance of eyebrow/eyelashes, (3) preparedness/information given, (4) impact of the hair loss of self, (5) impact of hair loss on others, (6) physiological side effects of loss of eyebrows/eyelashes, and (7) management of loss of eyebrows/eyelashes. In addition, participants noted physical symptoms of eye irritation during their treatment that they attributed to madarosis.Conclusion: This study highlights the significant impact of madarosis on patients, providing the first published analysis of patient's attitude and perception of eyelash and eyebrow loss during chemotherapy. Further research in this area is required and will be benefitted from the development of a dedicated instrument/questionnaire that can capture and measure the impact of madarosis on QoL and allow development of clinical trial strategies. [ABSTRACT FROM AUTHOR]

The purpose of this column is to highlight common medications in clinical dermatology V specifically, their usage, efficacy, side effects, and available alternatives. In this article, we discuss the mechanism of action, clinical use, secondary effects, and principle alternatives of topical bimatoprost 0.03% (trade name, Latisse). [ABSTRACT FROM AUTHOR]

Background: Hypereosinophilic syndrome is a hematologic disorder in which the eosinophils proliferate. Oral Janus kinase inhibitors are known to be effective treating hypereosinophilic syndrome. Janus kinase inhibitors have also demonstrated efficacy in alopecia. Madarosis is a condition in which the eyelashes are missing or absent and can been seen in alopecia patients.Case Presentation: We present the case of a 77-year-old Asian man who was diagnosed with hypereosinophilic syndrome, refractive to all medications except ruxolitinib. He responded well. It was noted unexpectedly that his eyelashes grew much longer than they were normally.Conclusions: Previous studies have demonstrated an improvement in alopecia areata, with increased hair growth on the head and eyebrows. This study demonstrates that longer eyelashes may be another effect of oral Janus kinase inhibitors. We report the first case of eyelash elongation and thickening in a patient taking ruxolitinib. Physicians and patients should be aware of the side effect of these Janus kinase inhibitors. Further investigation is needed to ascertain whether ruxolitinib or other interleukin inhibitors can aid in the treatment of madarosis. [ABSTRACT FROM AUTHOR]

Competing Interests: None disclosed.

Purpose: To report the newest ophthalmic manifestations of a mother-daughter pair diagnosed with toe syndactyly, telecanthus, anogenital and renal malformations (STAR) syndrome, a rare X-linked developmental disorder. Methods: The medical and ophthalmic records were reviewed for a mother-daughter pair diagnosed with FAM58A confirmed STAR syndrome on chromosome Xq28. Results: The m other at birth had left foot syndactyly, telecanthus, anal stenosis, and clitoromegaly and was told at 19 she had a hypoplastic left kidney. The daughter, born at 38 weeks after a complication of oligohydramnios, had a more severe presentation, demonstrating toe syndactyly, telecanthus, anal stenosis, clitoromegaly, bilateral renal hypoplasia, ureteral reflux, urogenital sinus, and congenital heart disease amongst others. The pair shared similar ophthalmic findings, though those of the daughter were more pronounced. They included bilateral, medial upper eyelid prominences with madarosis, mild peripapillary atrophy, and soft macular drusen with the daughter also displaying optic nerve hypoplasia and peripheral anterior synechia in the iridocorneal angle. Conclusion: These ophthalmic findings are the first reported to our knowledge in association with STAR syndrome. The literature frequently demonstrates that patients with developmental anomalies often have ocular manifestations, warranting a full ophthalmic examination when the diagnosis of STAR syndrome has been made or is being considered. [ABSTRACT FROM AUTHOR]

Olmsted syndrome (OS) is a rare congenital, mutilating palmoplantar keratoderma first described by Olmsted in 1927. It starts in the neonatal period or in childhood, and has a slow but progressive disabling course. We report the case of a 16-year-old boy who presented with keratoderma of the palm and soles since childhood with lateral supraciliary madarosis and clubbing. The patient was started on oral retinoids and topical keratolytics and had partial improvement in 2 months. Keratoderma of the palms and soles along with lateral supraciliary madarosis and clubbing in our case is a very rare finding, and to the best of our knowledge, has not been reported so far. [ABSTRACT FROM AUTHOR]

Alopecia areata is understood as an autoimmune disease T cell-mediated mainly involving hair follicles in humans. It is a multifactorial aetiologic disease characterised by non-scarring alopecia and asymptomatic areas, affecting approximately 2 % of dermatology patients. Recent studies suggest that the pathogenesis of AA plays an important role in the association of certain HLA groups, neuroendocrine parameters and immunogenic factors. During 3 months (March to May 2013) at Hospital Clínic de Barcelona, 22 patients with severe alopecia areata underwent ophthalmic examination to determine whether there were ocular findings in the following parameters: Best-corrected visual acuity on decimal Snellen optotype, anterior segment slit-lamp examination and photograph, intraocular pressure measurement and dilated fundoscopy. Ultra-wide-field retinal imaging with or without red-free photograph was carried out with the Optomap 200 Tx (Optos, DunFermline, UK). Forty-four eyes of 22 patients were analysed [15 females (68.2 %)]. The mean age was 38.9 (SD 13.7) and mean time of evolution was 19.9 years (SD 16.3). Alopecia areata clinical patterns were multifocal [ n = 10 (45.5 %)], universalis [ n = 7 (31.8 %)], totalis [ n = 3 (13.6 %)] and focal [ n = 2 (9.1 %)]. Best-corrected visual acuity was 1.0 in almost all patients, but only three eyes (6.8 %) had vision of 0.7. Ocular findings were as follows: madarosis [ n = 7 partial loss of eyelashes (31.85 %) and n = 4 total loss (18.2 %)], lens changes [ n = 4 (18.2 %)], cataract [ n = 3 (13.65 %)]. Ultra-wide fundus photography examination showed peripheral drusen [ n = 17 eyes (38.6 %)], white-without-pressure changes [ n = 8 eyes (18.22 %)] and peripheral retinal degenerations [ n = 3 eyes (6.81 %)]. Ocular findings in patients with alopecia areata are reported and discussed by dermatologic and ophthalmic evaluation. [ABSTRACT FROM AUTHOR]

Ichthyosis follicularis, alopecia, and photophobia (IFAP) syndrome is a rare genetic, oculocutaneous disorder. So far, about forty patients have been reported worldwide. This disorder results from mutations in the membrane-bound transcription factor protease site 2 gene that impairs cholesterol homeostasis and the ability to cope with endoplasmic reticulum stress. We report this rare case of IFAP with atypical presentation and it was interesting to note that alopecia in this child was confined to eyebrows; this unique presentation has not been described earlier. This rare oculocutaneous disorder requires proper documentation so that identification of its variants may be possible in the future. [ABSTRACT FROM AUTHOR]

Competing Interests: None disclosed.