Tinea Blepharociliaris: A Case Report and Literature Review.

Tinea blepharociliaris is a rare dermatophyte infection affecting the eyelashes and eyelids, often misdiagnosed as blepharitis, eczema, or bacterial infection, leading to ineffective treatments and recurrent symptoms. We report a case of a 10-year-old girl with erythematous plaques and fine scaling on the eyelids and eyelashes, initially suspected to have facial tinea or contact dermatitis. Direct mycological examination confirmed the presence of fungal filaments and spores, with culture identifying Trichophyton rubrum as the causative organism. Systemic and topical antifungal therapy resulted in complete resolution. Tinea blepharociliaris, though uncommon, mimics other periocular conditions, especially when modified by prior corticosteroid use. Differential diagnoses include primary and secondary causes of eyelash loss, such as chronic blepharitis and preseptal cellulitis. Clinicians should consider systemic antifungals for periocular dermatophyte infections involving hair-bearing areas, similar to the approach for tinea barbae and tinea capitis. Proper categorization, diagnosis, and treatment are essential to prevent misdiagnosis and ensure successful outcomes.