Eyelash trichomegaly: a systematic review of acquired and congenital aetiologies of lengthened lashes

Eyelash trichomegaly complicating pembrolizumab for colorectal cancer

INTRODUCTION

Pembrolizumab is an immune checkpoint inhibitor widely administered for the treatment of various malignancies. Despite its effectiveness, its distinctive mechanism of action may lead to immune-related adverse events, most frequently affecting cutaneous tissues. Hair-related adverse events, although uncommon, include conditions such as alopecia areata and alterations in hair texture or type.

CASE REPORT

A 63-year-old male patient presented with eyelash trichomegaly following two cycles of pembrolizumab infusion.

TREATMENT AND OUTCOME

The patient experienced discomfort due to the eyelash trichomegaly, prompting him to consider discontinuing the treatment. However, the patient's neoplastic disease demonstrated a complete radiologic response, which encouraged him to continue the therapy.

DISCUSSION

This case illustrates a unique documentation of pembrolizumab-induced eyelash trichomegaly. While immune checkpoint inhibitors like pembrolizumab are known to cause hair-related adverse events, reports of eyelash trichomegaly remain rare. This case emphasizes the necessity for clinicians to remain vigilant about such uncommon side effects to ensure comprehensive patient management.

Assessing clinical and morphological features of megalotrichosis induced by Tyrosine kinase inhibitors versus Prostaglandins analogues

PURPOSE

Describing the features of Megalotrichosis (MT) induced by Tyrosine kinase inhibitors (TKI) and differentiate it from Prostaglandins (PGs)-induced MT.

METHODS

Medical data of patients with MT referred to our center between 2012-2021 were retrieved for: demographic parameters, medical, surgical and oncologic background, and ophthalmologic background along with diagnoses and treatment. Time from PGs/TKI introduction to MT presentation, MT clinical characteristics, associated complaints, and prescribed therapies in relevant cases were also documented. Ophthalmologic exam, ocular photography and data retrieved from medical records were used to assess MT features among the two groups. Morphological evaluation included number of upper (UL) and lower lid (LL) eyelash rows, poliosis, individual elongated eyelash and eyelash curvature. Masked evaluation of all the patients was performed.

RESULTS

We found 11 patients, of which 6 treated with PGs for glaucoma and 5 treated with TKIs for non-ocular cancer suspected of dissemination. TKIs-induced MT was characterized by more individual elongated eyelashes (p = .047), UL eyelash rows (p = .03) and eyelash curvature (p = .076); poliosis characterized PGs-induced MT (p = .076). MT-associated complaints were more frequent in TKIs-induced MT (p = .06). time from drug administration to MT onset was shorter with TKI compared to PGs (median 176 Vs. 440 days, p = .257).

CONCLUSIONS

The study suggests that TKI-induced MT presents faster than PGs-induced MT and might be more bothering to patients. Knowledge of the morphological and clinical features that characterize each form of MT might be beneficial for patients and guide clinicians for intervention when needed. Larger cohorts are needed to reproduce and clarify our findings.

From Eye Care to Hair Growth: Bimatoprost

BACKGROUND

Bimatoprost has emerged as a significant medication in the field of medicine over the past several decades, with diverse applications in ophthalmology, dermatology, and beyond. Originally developed as an ocular hypotensive agent, it has proven highly effective in treating glaucoma and ocular hypertension. Its ability to reduce intraocular pressure has established it as a first-line treatment option, improving management and preventing vision loss. In dermatology, bimatoprost has shown promising results in the promotion of hair growth, particularly in the treatment of alopecia and hypotrichosis. Its mechanism of action, stimulating the hair cycle and prolonging the growth phase, has led to the development of bimatoprost-containing solutions for enhancing eyelash growth.

AIM

The aim of our review is to provide a brief description, overview, and studies in the current literature regarding the versatile clinical use of bimatoprost in recent years. This can help clinicians determine the most suitable individualized therapy to meet the needs of each patient.

METHODS

Our methods involve a comprehensive review of the latest advancements reported in the literature in bimatoprost formulations, which range from traditional eye drops to sustained-release implants. These innovations offer extended drug delivery, enhance patient compliance, and minimize side effects.

RESULTS

The vast literature published on PubMed has confirmed the clinical usefulness of bimatoprost in lowering intraocular pressure and in managing patients with glaucoma. Numerous studies have shown promising results in dermatology and esthetics in promoting hair growth, particularly in treating alopecia and hypotrichosis. Its mechanism of action involves stimulating the hair cycle and prolonging the growth phase, leading to the development of solutions that enhance eyelash growth. The global use of bimatoprost has expanded significantly, with applications growing beyond its initial indications. Ongoing research is exploring its potential in glaucoma surgery, neuroprotection, and cosmetic procedures.

CONCLUSIONS

Bimatoprost has shown immense potential for addressing a wide range of therapeutic needs through various formulations and advancements. Promising future perspectives include the exploration of novel delivery systems such as contact lenses and microneedles to further enhance drug efficacy and patient comfort. Ongoing research and future perspectives continue to shape its role in medicine, promising further advancements and improved patient outcomes.

Dermatological findings in Rubinstein-Taybi Syndrome

Rubinstein-Taybi Syndrome is a rare congenital multisystem syndrome inherited in an autosomal dominant pattern caused by mutations in CREBBP and EP300 genes in approximately 60% and 10% respectively. These genes encode two highly evolutionarily conserved, ubiquitously expressed, and homologous lysine-acetyltransferases, that are involved in number of basic cellular activities, such as DNA repair, cell proliferation, growth, differentiation, apoptosis of cells, and tumor suppression. It is mainly characterized by global developmental delay, moderate to severe intellectual disability, postnatal retardation, microcephaly, skeletal anomalies including broad/short, angled thumbs and/or large first toes, short stature, and dysmorphic facial features. There is an increased risk to develop tumors mainly meningiomas and pilomatrixomas, without a clear genotype-phenotype correlation. Although not considered as characteristic manifestations, numerous cutaneous anomalies have also been reported in patients with this entity. Both susceptibility to the formation of keloids and pilomatricomas are the most often associated cutaneous features. In this review, we discuss the genetics, diagnosis, and clinical features in Rubinstein-Taybi Syndrome with a review of the major dermatological manifestations.