Photoclinic: Poliosis

The lashes on this 12-year-old girl's right eye are white and gray; the lashes on the left eye are black. This small patch of white-gray hair, known as poliosis, occurs most often along the forehead (the so-called white forelock); however, hair anywhere on the body can be affected. The appearance in healthy persons simply indicates a lack of pigment in the hair and skin of the involved area.

Bhagwan Das Bang, MD, of Opp, Ala, writes that poliosis can affect persons of any age. It is associated with ocular chronic staphylococcal blepharitis, Waardenburg syndrome, Marfan syndrome, vitiligo, and Vogt-Koyanagi syndrome.

Waardenburg syndrome is characterized by dystopia canthorum, a broad nasal root, heterochromia iridis, congenital deafness, and a white forelock. Marfan syndrome has been associated with striae cutis distensae; hair abnormalities have rarely been reported. Vitiligo usually involves the skin, but often affects the hair as well; it is more prevalent in patients with thyroid disease (hypothyroidism or hyperthyroidism), adrenal insufficiency, pernicious anemia, and diabetes mellitus. Vogt-Koyanagi syndrome presents with vitiligo, uveitis, and premature graying of hair but also involves the CNS.

This patient's hearing was evaluated, and she was referred to an ophthalmologist. She showed no pathologic signs or symptoms and had no history of hereditary disease. Nevertheless, she will be followed closely by her pediatrician.