title: Eyelash alopecia areata: case series and literature review.
abstract: OBJECTIVE
  To characterize the clinical presentations, features, and outcomes of eyelash alopecia areata.
  
  
  METHODS
  Retrospective chart review of patients evaluated for eyelash loss and found to have eyelash alopecia areata. A 3-year follow-up was required.
  
  
  METHODS
  The study involved 15 patients.
  
  
  METHODS
  Patients who presented at a tertiary care eye clinic for evaluation of eyelash loss and were found to have eyelash alopecia areata were reviewed. Demographic considerations were categorized; they included age at presentation, areas of other hair loss, other relevant history, and treatment responses.
  
  
  RESULTS
  Patients were young (mean age 18 years) and had a large female predominance (female-to-male ratio, 14:1). Concurrent scalp and brow involvement, either in isolation (20% and 13%, respectively) or together (13%), were seen in half of the patients (46%). Upper eyelid involvement was more common and severe than lower eyelid involvement, and 40% of patients experienced complete regrowth of lashes, with a mean time to regrowth of 28 months (range, 6 to 60 months). Of these, 13% experienced partial regrowth. Younger age at presentation was associated with regrowth, whereas presence or absence of other involved sites, personal or family histories of atopy, family history of alopecia, other autoimmune diseases, or the use of topical steroids did not appear to affect prognosis.
  
  
  CONCLUSIONS
  Eyelash alopecia areata is a unique entity, although it remains potentially underdiagnosed. The key differential diagnosis is trichotillomania, which is commonly associated with obsessive-compulsive disorders. The presence of exclamation-mark hairs in alopecia areata plays an important role in differentiating the 2 diagnoses.
authors.affiliation: Eye Center, University of California, Davis School of Medicine, Davis, Calif., USA.
authors.forename: Bobeck S
authors.initials: BS
authors.lastname: Modjtahedi
authors.forename: Amar U
authors.initials: AU
authors.lastname: Kishan
authors.forename: Ivan R
authors.initials: IR
authors.lastname: Schwab
authors.forename: W Bruce
authors.initials: WB
authors.lastname: Jackson
authors.forename: Howard I
authors.initials: HI
authors.lastname: Maibach
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000506:Alopecia Areata / Q000175:diagnosis*; D002648:Child; D003937:Diagnosis, Differential; D005140:Eyelashes / Q000473:pathology*; D005141:Eyelid Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis; D012008:Recurrence; D012189:Retrospective Studies; D014256:Trichotillomania / Q000175:diagnosis; D055815:Young Adult