Sir,

Psoriasis may have extracutaneous manifestations affecting 1–3% of adults. The ocular manifestations of psoriasis are often subtle and may affect various parts of the eye, often going unnoticed without a thorough examination. Psoriatic plaques may be present on the eyelids, similarly to those found on other parts of the skin, with distinct features such as sharp margins, a dark red hue, and grayish scales. Psoriatic blepharitis is a more common occurrence on the eyelids, and other associated conditions may include non-specific conjunctivitis, corneal involvement, and uveitis [1].

Managing psoriasis on the eyelids is challenging due to the potential side effects of topical corticosteroids applied to this area. Phototherapy is an alternative treatment option, and tacrolimus and pimecrolimus are currently valid alternatives due to their good skin and ocular safety profiles [2].

There are currently no established screening criteria for identifying ophthalmic complications in patients with psoriasis. As a result, all individuals with psoriasis should undergo routine screening for associated ocular manifestations, such as dry eye, blepharitis, conjunctivitis, and uveitis [3]. Herein, we report the case of a patient who presented with chronic blepharitis revealing psoriasis.

A 37-year-old female patient with no previous pathological history consulted for a pruritic edema of the eyelids with scales on the eyelashes evolving for four years with episodes of flare-ups and remissions. A clinical examination revealed a patient of Fitzpatrick phototype V with thick, whitish scales adhering to the base of the eyelashes bilaterally with slight edema and a crumpled appearance of the eyelids without visible erythema. Dermoscopy revealed whitish scales and a patchy, erythematous background (Figs. 1a and 1b). Examination of the rest of the integument revealed erythematous, squamous plaques on the vertex with a positive methodical Brocq scratch and a positive Auspitz sign (Figs. 2a and 2b) confirming the diagnosis of psoriasis. A meticulous interrogation revealed the concomitant appearance of palpebral and scalp lesions evolving by episodes of relapse and remission. Treatment with topical dermocorticoids was instituted on the scalp and eyelids with good evolution.

	Figure 1: (a) Clinical image: whitish scales at the base of the lashes with a crumpled appearance of the eyelid. (b) Dermoscopy: thick, whitish scales and an erythematous background.
	Figure 2: (a) Clinical image: erythematous, scaly plaque on the vertex. (b) Dermoscopy: vessels in homogeneous points and thick, whitish scales.