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CASE REPORT
Year : 2017  |  Volume : 18  |  Issue : 4  |  Page : 303-305

An unusual case of familial trichomegaly


1 Department of Paediatrics, Jagannath Gupta Institute of Medical Sciences, Kolkata, West Bengal, India
2 Department of Pathology, Jagannath Gupta Institute of Medical Sciences, Kolkata, West Bengal, India
3 Hospital Administration, Jagannath Gupta Institute of Medical Sciences, Kolkata, West Bengal, India

Date of Web Publication29-Sep-2017

Correspondence Address:
Joydeep Das
Natural Top, 77A Christopher Road, Kolkata - 700 046, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpd.IJPD_50_17

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  Abstract 


Trichomegaly is an unusual disorder of abnormally long eyelashes. Although the abnormality in itself does not cause any problems, except the cosmetic issues, however, it may be associated with syndromes, in which case it requires detailed investigations. Here, we describe a case of familial trichomegaly, involving mother and two siblings, which is an unusual entity.

Keywords: Case report, eyelash, trimming


How to cite this article:
Das J, Sarker D, Pal D, Mondal S, Gupta B. An unusual case of familial trichomegaly. Indian J Paediatr Dermatol 2017;18:303-5

How to cite this URL:
Das J, Sarker D, Pal D, Mondal S, Gupta B. An unusual case of familial trichomegaly. Indian J Paediatr Dermatol [serial online] 2017 [cited 2019 Oct 16];18:303-5. Available from: http://www.ijpd.in/text.asp?2017/18/4/303/215794




  Introduction Top


Trichomegaly is an unusual disorder. Familial trichomegaly is even rarer. In some cases, detailed investigations are necessary, especially those associated with syndromes, to exclude an underlying disorder. However, in other cases, cosmetic issues may be the only problem encountered.


  Case Report Top


A 4-year-old male child visited the Pediatric Department for minor ailments such as cough and cold and was incidentally detected to have abnormally long eyelashes [Figure 1]. His ophthalmological examination was normal with respect to visual acuity and cycloplegic refraction. Ocular media was clear, and fundus was normal. No hypopigmentation or depigmentation was noted.
Figure 1: Long eyelash

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On further questioning, his sister (6 years) and mother (38 years) were both revealed to have abnormally long eyelashes requiring regular trimming and epilation. Father was unaffected. No other family members had long eyelashes both from paternal and maternal side.

All investigations (complete blood count, thyroid profile, liver function tests, luteinizing hormone, follicle-stimulating hormone, and radiology for bone age) of both the siblings and the mother were normal. Serology for HIV, hepatitis B, and hepatitis C was negative. Ultrasound examination of the abdomen and ophthalmological examination were normal for all three of them.

Trimming or epilation of the eyelashes was advised. Despite the fact that the siblings did not have any complaints, follow-up was recommended for potential ocular side effects [Figure 2].
Figure 2: Eyelash microscopy showed thick inner cortex proportionate to length

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On microscopic examination, no difference was noted between a normal eyelash and eyelash from our patient.


  Discussion Top


Trichomegaly (abnormally long eyelashes) was first described by Reiter in 1926, attributed to adrenal dysfunction. Bab in 1931 described a second case of trichomegaly in a 9-year-old girl, in the absence of other pathology. Gray [1] in 1944 described a third example of this condition in a 64-year-old man and coined the term trichomegaly or “movie lashes.” In 2016, Tamer and Yuksel [2] described a case of familial trichomegaly in a brother and a sister.

Eyelash trichomegaly is an uncommon condition which describes increased length (12 mm or greater), thickness, stiffness, curling, and pigmentation of the eyelashes.[3],[4] The exact mechanism of eyelash trichomegaly remains unknown; however, immune system dysregulation, epidermal growth factor receptors, and prostaglandins seem to have an important role in the etiopathogenesis.[4] Its true incidence remains unknown, but it affects adults much more than children. Eyelash trichomegaly has been reported as an isolated feature in most cases. However, it can be accompanied by generalized acquired hypertrichosis and malar-eyebrow hypertrichosis in some patients.[3],[5]

Trichomegaly of eyelashes may be familial, or it may occur as a part of congenital syndromes such as Oliver–McFarlane syndrome, Cornelia de Lange syndrome, and Hermansky–Pudlak syndrome. Familial eyelash trichomegaly is characterized by patients whose family members have similar findings.[4] Eyelash trichomegaly has been reported with several diseases including alopecia areata, systemic lupus erythematosus, dermatomyositis, human immunodeficiency virus infection, atopic dermatitis, allergic rhinitis, and uveitis. In addition, treatment with cyclosporine, tacrolimus, topical prostaglandins, topiramate, zidovudine, and epidermal growth factor receptor inhibitors such as cetuximab, erlotinib, gefitinib, and panitumumab may cause overgrowth of the eyelashes as a side effect. It has been also suggested that patients with human immunodeficiency virus infection and allergic diseases would have long and silky eyelashes whereas epidermal growth factor receptor inhibitors would lead to coarse and tortuous eyelashes.[4]

Patients with eyelash trichomegaly are usually asymptomatic; thus, treatment is not necessary in most cases. Nonetheless, patients can suffer from cosmetic problems. Severe cases may present with visual discomfort, mechanical ptosis, and corneal ulcers as a result of trichiasis.[4] However, epilation and trimming of the long eyelashes have been reported as effective treatment options.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Gray H. Trichomegaly or movie lashes. Stanford Med Bull 1944;2:157-8.  Back to cited text no. 1
    
2.
Tamer F, Yuksel ME. Familial eyelash trichomegaly: The case of a sister and a brother. Indian J Dermatol Venereol Leprol 2016;82:700-2.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Rossetto JD, Nascimento H, Muccioli C, Belfort R Jr. Essential trichomegaly: Case report. Arq Bras Oftalmol 2013;76:50-1.  Back to cited text no. 3
    
4.
Paul LJ, Cohen PR, Kurzrock R. Eyelash trichomegaly: review of congenital, acquired, and drug-associated etiologies for elongation of the eyelashes. Int J Dermatol 2012;51:631-46.  Back to cited text no. 4
[PUBMED]    
5.
Almagro M, del Pozo J, García-Silva J, Martínez W, Castro A, Fonseca E. Eyelash length in HIV-infected patients. AIDS 2003;17:1695-6.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2]



 

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