Abstract ID: 26-289
Delayed Periorbital Vitiligo Following Upper Eyelid Blepharoplasty: A Possible Koebner Phenomenon
Author: Fadi Hassanin Base Hospital / Institution: University of Jeddah/ Saudi Arabia
Presentation Type: ePoster Presentation
Purpose
To report a rare case of delayed-onset periorbital vitiligo following uneventful upper eyelid blepharoplasty and to highlight surgical trauma as a potential trigger via the Koebner phenomenon.
Methods
Observational case report with serial clinical photographic documentation and focused literature review.
Results
A healthy female patient underwent bilateral upper eyelid blepharoplasty with an uneventful postoperative course. At 2 months, healing was excellent with well-concealed scars. Approximately 18 months postoperatively, the patient developed progressive hypopigmentation localized to the left peribrow region adjacent to the surgical site. There was no personal or family history of vitiligo, autoimmune disease, periocular trauma, or exposure to topical irritants. Clinical examination demonstrated a well-demarcated, non-scaly, non-atrophic depigmented patch. Wood’s lamp examination showed bright accentuation of the lesion, supporting the diagnosis of vitiligo, while the surgical scar remained flat and well healed. The delayed onset, distribution, and morphology were most consistent with vitiligo triggered by surgical trauma through the Koebner phenomenon. A focused literature review identified only isolated reports of periocular depigmentation following eyelid procedures, with no well-documented cases specifically after cosmetic upper eyelid blepharoplasty. Treatment with topical tacrolimus and strict photoprotection was initiated.
Conclusion
Vitiligo may rarely develop following oculoplastic procedures despite initially uneventful healing. The delayed onset of depigmentation approximately 18 months after surgery is consistent with a delayed Koebner response to surgical trauma. Similar periocular cases are scarce, and reports following cosmetic blepharoplasty are exceptionally limited. Recognition is important to differentiate from scar-related hypopigmentation and to guide conservative management.