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Dermoscopy of cilia incarnatum externum

 Department of Dermatology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India

Date of Submission30-Aug-2019
Date of Decision29-Oct-2019
Date of Acceptance21-Dec-2019
Date of Web Publication19-Sep-2020

Correspondence Address:
Sradda N Kona,
OPD 16, Department of Dermatology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra - 400 022
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/idoj.IDOJ_443_19

How to cite this URL:
Agrawal S, Kona SN, Dhurat RS, Daruwalla SB. Dermoscopy of cilia incarnatum externum. Indian Dermatol Online J [Epub ahead of print] [cited 2021 Jan 21]. Available from: https://www.idoj.in/preprintarticle.asp?id=295461

A 5-year-old male child presented to the skin clinic with an asymptomatic small bump at right upper eyelid which developed 1 month after healing of a stye over the same site. On examination, there was a skin-colored papule present on the lower margin of the right upper eyelid [Figure 1]. There were no other associated abnormalities. We thought of differentials such as foreign body, pediculosis, solitary trichoepithelioma, and syringoma. Dermoscopy was performed with nonpolarized light, and a hair was seen originating from the margin of the eyelid, directed upwards (misdirected cilium). Skin markings were visible above the hair signifying that it was embedded below the epidermis [Figure 2]a. On polarized light microscopy, the misdirected cilium was visualized more clearly [Figure 2]b. As a result of dermoscopy, we were able to see the origin of the hair to reach the accurate diagnosis of cilia incarnatum externum.
Figure 1: A small skin colored papule present on the right upper eyelid

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Figure 2: (a) Non-polarized dermoscopy, hair was seen originating from the margin of the eyelid, directed upwards. (b) Polarized dermoscopy, misdirected cilium was visualized more clearly [Dino-Lite -AM4113ZT 10×-50×, Polarizing mode]

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Cilia incarnata (cilium incarnatum externum and cilium incarnatum internum) are rare anomalies in which the eyelash hair is misdirected. It grows underneath the skin either outwards or inwards in an abnormal direction.[1] This corresponds to pili incarnati (ingrown hair) which is common in the beard or area near the legs.[2] Due to obstruction in the process of its growth, the emerging eyelash tends to take the path of least resistance.[3]

The mainstay of treatment in both the conditions is epilation and recurrence is rare as the root is in a normal position. However, in some cases where recurrence occurs, cryotherapy or radiofrequency cautery can be done.[4]

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.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Duke-Elder S. System of Ophthalmology. St. Louis, Missouri: Mosby; 1963.  Back to cited text no. 1
Weninger G. Sur les poils incarnés. Ann Dermatol Syph 1928;9:687.  Back to cited text no. 2
Bloch FJ. Minor anomalies in position of the eyelashes. Arch Ophthal 1947;37:772-4.  Back to cited text no. 3
Patel BC, Malhotra R. Cilia Incarnata. [Updated 2019 Apr 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019.  Back to cited text no. 4


  [Figure 1], [Figure 2]


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