Which statement about blepharitis is NOT true?

• A. The two main types are staphylococcal and seborrheic
• B. Staph blepharitis can only cause anterior blepharitis
• C. Seborrheic blepharitis is associated with a more oily, greasy looking appearance
• D. Seborrheic blepharitis is more associated with madarosis compared to staph blepharitis

Answer: (B)

Blepharitis is typically discussed in terms of anterior disease, caused mainly by two etiologies—staphylococcal infection and seborrheic dermatitis—and posterior disease, driven by meibomian gland dysfunction. Staphylococcal blepharitis is the classic cause of anterior lid-margin inflammation, but it is not limited to anterior involvement. Chronic or widespread inflammation from Staphylococcus can extend influence to the posterior lid margin, or coexist with meibomian gland dysfunction, so it can contribute to posterior blepharitis as well. That’s why the statement claiming staphylococcal blepharitis can only cause anterior blepharitis is not true.

The other points fit with this understanding: the two main anterior forms are staphylococcal and seborrheic; seborrheic blepharitis often has a greasy appearance; and seborrheic blepharitis is more frequently associated with madarosis compared to staphylococcal blepharitis.