Dear Editor, Eyelash trichomegaly is a rare condition defined as excessive elongation, increased thickness, or pigmentation. This can be congenially observed or induced by other conditions and medications. However, the precise mechanism has not been fully elucidated. Here, we report a case of eyelash trichomegaly following diffuse hair loss associated with transient malnutrition. A 10-year-old Japanese girl presented with eyelash elongation up to 16 mm following diffuse alopecia of her scalp (Fig. 1a). Her hairs were fine, hypopigmented and easily breakable. Regrown hairs showed a striped pattern, in which a hypopigmented, tapered part existed between dark-colored, normal-surfaced parts, mimicking "flag sign of kwashiorkor" (Fig. 1b,c). Patchy hair loss or exclamation mark hairs had not been experienced before the symptoms. She has been diagnosed as having congenital hydrocephalic anencephaly and gastroesophageal reflux, and for the latter condition, enteral nutrition through gastrostoma following laryngotracheal separation had been performed. The patient showed difficulty of nutrition because of increased reflux for several weeks prior to the hair symptoms.
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