(5) In extreme instances, toxic effects can manifest as paronychia, facial hypertrichosis, and trichomegaly
. These skin changes can be deforming as well as painful, and can have physiological and psychological consequences.
HAIR CHANGES: Hair changes included diffuse alopecia of the scalp seen in 27 (18%) cases followed by trichomegaly in 10(6.67%) patients.
Trichomegaly (elongation of eyelashes) was seen in 10 (6.67%) patients.
It is suggested that viral activity plays an important role in the pathogenesis of trichomegaly. Some viral protein may be directly stimulatory to epidermal keratinocytes and pilosebaceous structures.
External eye manifestations are quite common and range from the innocuous trichomegaly
(long eye lashes) to proptosis caused by orbital cellulitis or lymphoma (life-threatening if not managed appropriately).
, increase in periocular pigmentation and adnexal hair growth are well-known periocular changes.
Hypertrichosis on the face can be alleviated with depilatories and trichomegaly with trimming.
Trichomegaly: excessive hair growth of the eyelashes and eyebrows Uncomplicated diarrhea: grade 1 or 2 diarrhea with no complications.
Paronychia, fissures, xerosis, alopecia, eyelash trichomegaly
, telangiectasias, and photosensitivity also can occur.
(19-22) Some patients also experience trichomegaly
(abnormally long eyelashes), keratoconjunctivitis sicca (dry eyes with hardening of the cornea) and conjunctivitis.