Bilateral Eyelash Poliosis with Raccoon Erythema and Hypopigmentation: Contact Follicular Leukoderma

The document reports a rare case of contact follicular leukoderma in a 36-year-old male with uveitis, presenting as bilateral eyelash poliosis and periocular hypopigmentation, initially suspected to mimic Vogt-Koyanagi-Harada (VKH) syndrome. The condition was linked to the use of topical eyedrops containing preservatives like benzalkonium chloride and cetrimide, which may have caused melanocyte apoptosis or inflammation. Despite a negative patch test, the temporal association with topical therapy suggested contact leukoderma or steroid-induced hypopigmentation. The study highlights the diagnostic challenge in differentiating between vitiligo and contact leukoderma, as initial contact leukoderma may trigger an autoimmune response leading to vitiligo. Further research is needed to understand the pathomechanism and etiological agents in the eyedrops responsible for these unusual presentations.