In patients with hypothyroidism the most common findings on examination were xerosis 23 (71.9%), diffuse hair loss 18 (56.3%), cool and pale extremities 17 (53.1%) followed by puffiness of face 12 (37.5%), goitre 6 (18.7%), madarosis
5 (15.6%), nail changes 6 (18.7%).
The patient had ciliary and superciliary madarosis
with loss of the lateral third of the eyebrows.
Lid margin inlammation disrupts the anatomy of the eyelid and might lead to misdirection of lashes, especially in chronic cases (trichiasis --Figure 5), loss of lashes (madarosis
) and poliosis (loss of lash pigmentation).
Chaung SD et al.,: Familial acanthosis nigricans with madarosis
Physical examination revealed polymorphous necrotic-haemorrhagic macules with irregular shapes, angulated or 'stellar' on the lower extremities, buttocks and trunk (Figure 1), the collapse of the nasal pyramid, madarosis
, atrophy of both auricular lobes, diffuse infiltration of the skin of the trunk, atrophy of both thenar and hypothenar eminences of both hands, with flexion of the proximal interphalangeal joints and claw fingers of both hands.
Bilateral infiltration of ears and face with madarosis
was present (Fig.
leprae also causes dacryoadenitis and supra-cilliary or cilliary madarosis
while facial nerve involvement will manifest in lagophthalmos and eyelid deformity (ectropion, entropion, or trichiasis).
1 (7.6%) case was brought to the leprosy centre with madarosis
. In one (7.6%) patient recurrent bleeding from the nose was also seen.
Ocular complications include exposure keratitis secondary to ectropion, blepharitis, absence of the meibomian gland, trichiasis, madarosis
, and absence of lacrimal puncta.
There was no family history of Hansen's disease and mucocutaneous examination revealed no madarosis
, infiltration or light coloured lesions.
Eyebrows were normal with no evidence of madarosis
. Lid revealed periorbital edema of both upper lids (Vigouroux sign) and lower lids (Enroth's sign).