Eyelash Loss: An Unusual Manifestation of Uncontrolled Hypothyroidism

TL;DR

A young woman with uncontrolled hypothyroidism experienced eyelash loss, which improved after treatment with levothyroxine.

Contribution

This case highlights milphosis and madarosis as rare but important signs of uncontrolled hypothyroidism.

Findings

Significant eyelash loss was observed in a patient with severe uncontrolled hypothyroidism.

Levothyroxine treatment led to full eyelash regrowth and resolution of periorbital edema within 12 weeks.

The case underscores the importance of recognizing unusual dermatological symptoms in hypothyroidism.

Abstract

Hypothyroidism commonly presents with dermatological and hair-related symptoms, although the loss of eyelashes and eyebrows is considered uncommon in clinical practice. Here, we present a case of milphosis secondary to uncontrolled hypothyroidism.

A 24-year-old female with a history of hypothyroidism following total thyroidectomy and poor medication adherence presented with significant eyelash loss, accompanied by symptoms of dysphonia, bradyphrenia, bradylalia, constipation, pronounced fatigue, and drowsiness. Physical examination revealed periorbital edema and extensive eyelash loss affecting the upper eyelids. Laboratory analysis demonstrated a markedly elevated thyroid-stimulating hormone (TSH) level of 240.8 µIU/mL (normal range 0.38 to 5.33 µIU/L), confirming severe uncontrolled hypothyroidism. Levothyroxine treatment was reintroduced, leading to complete resolution of periorbital edema and regrowth of eyelashes after 12 weeks, coinciding with improvement in TSH levels.

This clinical case adds to the limited literature on madarosis and milphosis as manifestations of hypothyroidism, emphasizing the importance of clinician awareness regarding their potential presentation in the context of the disease. Understanding these manifestations and their differential diagnoses is crucial for ensuring prompt and accurate diagnosis and treatment.

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