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[Clinical Picture] Persistent red and swollen eyelids

A 44-year-old woman presented with a 3-year history of having swollen and red eyelids. The problem was not associated with pruritus or pain. She had been previously treated with topical steroids and antibiotics but with little effect. Her past medical history was unremarkable. During physical examination, she was found to have scaly, atrophic, erythematous plaques—with the loss of eyelashes on the lateral aspects—on both lower eyelids (figure). Additionally, the scaly erythema was accompanied by hyperpigmentation on the left lateral canthus (figure).