Beyond the Margins – Ectopic Cilia: A Clinical Rarity

Ectopic cilia, a rare anomaly, manifest as the growth of eyelash follicles in atypical locations, deviating from their usual location along the eyelid margin. The embryological origins of this condition remain elusive; while previously linked to meibomian gland substitution, this theory has since been dismissed. A 5-year-old male presented with asymptomatic hair growth over the right upper eyelid since birth with no history of trauma, infection, or atopy. Upon examination, a grouped cluster of hair, morphologically similar to the eyelashes, was observed on the lateral aspect of the right upper eyelid, just above the eyelid margin [Figure 1]. Dermoscopy under polarized mode, in × 10, showed a cluster of 15–16 hair follicles [Figure 2].Figure 1: Clinical image showing a cluster of hair, indicating ectopic ciliaFigure 2: Dermoscopic examination under polarized mode, in × 10 shows the close-up view of 15–16 hair folliclesEctopic cilia manifest in two forms: the anterior type which is usually congenital and unilateral, occurs most commonly, at the junction of medial two-thirds and lateral one‐third, on the outer aspect of the upper eyelid. This site is embryologically, a watershed area of two angiosomes: the superficial temporal artery and the termination of the facial artery.[1] The posterior type is usually acquired and commonly presents as a solitary lash beneath the upper or lower conjunctiva. Ectopic cilia have been associated with congenital distichiasis, dermoid cysts, complex choristoma, atopic eczema around the eye, preseptal cellulitis, nail-patella syndrome, and hypochromic nevus.[2] Surgical removal is the primary treatment since other modalities like epilation or cryosurgery show frequent recurrence. Research on the embryological origin, potential genetic predisposition, and various associations are required for a clearer understanding of this aberration, as to the best of our knowledge, there are few cases reported worldwide. Declaration of consent The authors certify that they have obtained all appropriate consent forms, duly signed by the parent(s)/guardian(s) of the patient. In the form, the parent(s)/guardian(s) has/have given his/her/their consent for the images and other clinical information of their child to be reported in the journal. The parents understand that the names and initials of their child/children will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.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.