Loss of eyelashes may occur with several conditions, including a variety of skin diseases, drug side effects, endocrine disorders, metabolic abnormalities, traumatic insults, inflammations, toxins, psychiatric disorders, and systemic disease. If the history and results of clinical, laboratory, and consultative assessments are negative, one must consider the possibility the patient is pulling them out (trichotillomania). Three case reports of spontaneous lash loss are described-one secondary to trichotillomania, one a result of hypothyroidism, and another with features of both hypothyroid and trichotillomania-to illustrate the presentation and appropriate workup to obtain a diagnosis.
Keywords: Lash loss; allopecia; madarosis; milphosis; trichotillomania.