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Dermoscopy of cilia incarnatum externum
Sandip Agrawal, Sradda N Kona, Rachita S Dhurat, Sanober B Daruwalla
Department of Dermatology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India
| Date of Submission | 30-Aug-2019 |
| Date of Decision | 29-Oct-2019 |
| Date of Acceptance | 21-Dec-2019 |
| Date of Web Publication | 19-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
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/idoj.IDOJ_443_19
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 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.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
 References | |  |
| 1. | Duke-Elder S. System of Ophthalmology. St. Louis, Missouri: Mosby; 1963.  |
| 2. | Weninger G. Sur les poils incarnés. Ann Dermatol Syph 1928;9:687. |
| 3. | Bloch FJ. Minor anomalies in position of the eyelashes. Arch Ophthal 1947;37:772-4. |
| 4. | Patel BC, Malhotra R. Cilia Incarnata. [Updated 2019 Apr 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019. |
[Figure 1], [Figure 2]
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