Unique eyelid manifestations in type 1 pseudohypoaldosteronism Physical examination was normal except for the eyelid fi ndings as evident in fi gure 1. Prominent white projections on the margin of all four eyelids represent abnormal sebum collection resulting from the sodium channel defect in PHA1. Also noted was dry, rough and a parchment-like skin texture.To summarise, autosomal-recessive PHA 1 is a condition that results in a life-threatening electrolyte and acidbase imbalance during the immediate neonatal period. The noted association of this condition with the characteristic physical sign visible at birth might facilitate a lifesaving early diagnosis.

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