Unilateral Madarosis Revealing Blepharitis Caused by Microsporum audouinii: A Case Report

Madarosis, defined as partial or total loss of eyelashes, is an unusual symptom that can reveal a variety of underlying conditions. We report a rare case of unilateral madarosis associated with blepharitis caused by Microsporum audouinii, a dermatophyte responsible for ringworms. An eight-year-old boy presented with ocular pruritus with erythematous squamous lesions of the right eyelid evolving for four days. An initial diagnosis of eczematous blepharitis was made, and symptomatic treatment was initiated. However, the evolution was unfavorable, marked by the appearance of madarosis. The patient's clinical examination revealed chronic mixed blepharitis, while his sister had scalp ringworm. Mycological examination of the palpebral scales and eyelashes revealed Microsporum audouinii, leading to the diagnosis of blepharitis secondary to dermatophytosis. We initiated an appropriate antifungal treatment, both systemic and topical, resulting in favorable clinical evolution. We noticed a progressive regrowth of the eyelashes and complete resolution of the palpebral lesions. This case illustrates the importance of considering infectious etiologies, including fungal infections in the differential diagnosis of atypical blepharitis resistant to treatment, indicating the importance of a microbiological examination. An early and appropriate treatment can prevent chronic complications, particularly madarosis.