Special Groups
Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan in Comprehensive Textbook on Vitiligo, 2020
Leukotrichia is seen in 3.7%–25% of childhood vitiligo cases [12]. Localized hair follicles of scalp can be involved, leading to poliosis, and this is more commonly seen in segmental vitiligo (Figure 15.2.4). Poliosis has been observed in 55.55% of children with vitiligo [9]. Scalp leukotrichia is a common finding in children with family history of vitiligo and other autoimmune disorders. Premature graying was found to be more common among first- and second-degree relatives of children with vitiligo. In a study by Jaisankar et al., 4.4% of vitiligo children had premature graying of hair [15]. Some children manifest with total depigmentation of scalp hair, eyebrows, and eyelashes. Poliosis has also been reported to occur in nevus depigmentosus and needs to be differentiated from vitiligo [16].
Disorders of Keratinization and Other Genodermatoses
Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang in Roxburgh's Common Skin Diseases, 2022
Clinical presentation: In addition to generalized vitiligo, which may have been present for a while, inflammation of tissues with melanocytes can occur, including panuveitis, sensorineural hearing loss, vertigo, and tinnitus. The standard VKHS begins with headaches, malaise, and eye pain for a few days accompanied by acute neurologic symptoms, such as transverse myelitis, cranial nerve palsies, hemiparesis, and optic neuritis. The second stage involves acute uveitis, the third stage involves extensive depigmentation that is rapid in onset and spread, and the fourth stage involves chronic relapsing uveitis in which retinal fibrosis can occur. Alopecia and poliosis can also be noted.
Principles of Clinical Diagnosis
Susan Bayliss Mallory, Alanna Bree, Peggy Chern in Illustrated Manual of Pediatric Dermatology, 2005
Vitiligo PoliosisPremature graying of hairHypo- or hyperpigmentationAtrophy of the skinChronic skin infections
Eyelash poliosis associated with Vogt-Koyanagi Harada disease
Published in Clinical and Experimental Optometry, 2023
Gladys Rodrigues, Teena Mendonca
Poliosis is the absence or reduction in melanin content in hair anywhere in the body. Poliosis can be caused by a spectrum of benign, autoimmune or neoplastic conditions.1 Vogt-Koyanagi-Harada (VKH) is an autoimmune disease with multisystem involvement2 and can cause poliosis in late stages. VKH predominantly affects tissues with melanocytes such as the skin, central nervous system, eyes and inner ears. Most patients present with acute onset loss of vision, bilateral panuveitis and exudative retinal detachment. The disease has a variable presentation and diagnosis is aided by investigations such as fundus fluorescein angiography and optical coherence tomography. Skin changes such as vitiligo and poliosis are late manifestations and help in making a diagnosis of complete Vogt-Koyanagi-Harada (ocular with neurological and integumentary).3 Early and complete treatment results in resolution of exudative detachment and associated visual recovery. However, pigmentary changes in the choroid, poliosis and skin changes usually persist despite therapy.
Management of open‐angle glaucoma by primary eye‐care practitioners: toward a personalised medicine approach
Published in Clinical and Experimental Optometry, 2021
Jack Phu, Ashish Agar, Henrietta Wang, Katherine Masselos, Michael Kalloniatis
Prostaglandin analogues, being more frequently prescribed, have primarily local side‐effects, but these may also have cosmetic implications for patients of different ages. Most notably, the sunken upper eyelid is often associated with an aged appearance, and has been the trigger for cosmetic surgical treatments.225,226 The eyelashes may also decrease in length, thickness and darkness (pigmentation) with age, which may be ‘treated’ by prostaglandin treatment;227 for some patients there may therefore be a perceived cosmetic benefit to prostaglandin use.228 However, some patients may also develop poliosis of the eyelashes and hair growth elsewhere on the face,229–231 which are conversely cosmetically undesirable.232 From a practical perspective, these cosmetic changes may present challenges to spectacle wearers (where eyelash lengthening affects the back vertex distance), and from the perspective of a clinician, the periorbitopathy may present a challenge for performing applanation tonometry.233
Management of Chronic Hypotony Following Bilateral Uveitis in a Patient Treated with Pembrolizumab for Cutaneous Metastatic Melanoma
Published in Ocular Immunology and Inflammation, 2019
Gerard Reid, Paul Lorigan, Heinrich Heimann, Marta Hovan
We report a case of bilateral panuveitis uveitis in a 73-year-old man following treatment with pembrolizumab (2 mg/kg IV every 3 weeks) for cutaneous metastatic melanoma that was refractory to ipilimumab. The patient was referred to ophthalmology with reduced visual acuity (VA). This coincided with auditory symptoms of reduced hearing which varied in severity over 1 week. On review, he had bilateral findings of intraocular inflammation with anterior chamber (AC) and anterior vitreous cells, choroidal thickening, and disk swelling (Figure 1). Extensive posterior synechiae were present in the left phakic eye. The right eye was pseudophakic following previous phaco-vitrectomy for retinal detachment repair. His VA was 6/18 and 6/24 in the right and left eyes respectively and presenting intraocular pressure (IOP) was 8 mmHg in both eyes. During follow-up, poliosis of the eyelashes and eyebrows was noted.
Related Knowledge Centers
- Alopecia Areata
- Hair Follicle
- Piebaldism
- Waardenburg Syndrome
- Melanin
- Melanocyte
- Vitiligo
- Neurofibromatosis Type I
- Tuberous Sclerosis
- Vogt–Koyanagi–Harada Disease