Two brothers (both younger than 13 years) were evaluated for eyelid margin lesions (Figure). Lesions were present on all 4 lids in both boys. The lesions were itchy and did not respond to steroid or antibiotic therapy. Demodex test results were negative and tea tree oil was ineffective. A full-thickness eyelid biopsy showed dense deposits of eosinophilic hyaline material in the dermis. The lesions are examples of the moniliform blepharosis of lipoid proteinosis.