Erlotinib induced trichomegaly of the eyelashes

Periocular Manifestations of Afatinib Therapy

Epidermal growth factor receptor tyrosine kinase inhibitor therapy has been increasingly employed in the treatment of a variety of tumors. The authors report the rarely documented side effect of trichiasis with the use of Afatinib in a patient with spinal chordoma and review-related literature. A 67-year-old lady was referred to the oculoplastic service with a 3-month history of ocular irritation and pain associated with blurred vision. She has a 4-year history of spinal chordoma treated with daily Afatinib 50 mg over the past 6 months. Clinical examination revealed trichomegaly and trichiasis affecting all 4 eyelids associated with blepharitis, conjunctival, and corneal abrasion on fluorescein staining. Hypertrichosis of the eyebrow bilaterally was also present. Afatinib and other epidermal growth factor receptor tyrosine kinase inhibitor-associated changes to eyelash and eyebrow hair is a result of epidermal growth factor receptor pathway activation in keratinocytes results in remodeling of the hair follicle. This results in the variation in the severity of clinical presentation of trichiasis.

Eyelashes Trichomegaly: An Unusual Side Effect of Gefitinib Therapy

Evolution of targeted therapy has changed the spectrum of treatment in oncology since the past two decades as lots of newer agents are being added to the pharmacologic armamentarium of cancer therapy. Epidermal growth factor receptor inhibitors form one such advancing field with many newer agents being investigated and they are used in wide variety of malignancies such as head and neck cancer, lung cancer, and even gastrointestinal malignancies such as pancreatic cancer. Various troublesome side effects of these agents include diarrhea, severe fatigability, severe skin rashes, and deranged liver function tests which may require treatment interruption or dose reduction resulting in decreased response to treatment. However, some of the side effects may not require dose modification but incidentally observed and does not impact patient's quality of life. One such effect is trichomegaly which is very rarely observed with such agents. Herein, this conversation we report a 52-year-old female case of metastatic carcinoma lung who developed trichomegaly of eyelashes while on gefitinib therapy.

Eyelash trichomegaly following treatment with erlotinib in a non-small cell lung cancer patient: A case report and literature review

Inhibitors of epidermal growth factor receptor (EGFR), including tyrosine kinase inhibitors (TKIs), present significant clinical benefits in the treatment of non-small cell lung cancer (NSCLC), particularly in patients with an EGFR mutation. However, TKI treatment also results in unwanted cutaneous toxic side effects, such as a skin rash. Eyelash trichomegaly is rarely reported as a side effect; however, it causes cosmetic issues or eyeball irritation in patients, which may result in the early termination of TKI treatment. Therefore, although TKI-induced eyelash trichomegaly is rare, it should be considered carefully by lung cancer physicians. The present study reported a case of erlotinib-induced eyelash trichomegaly in a 65-year-old Chinese female patient suffering from NSCLC with an EGFR mutation. To the best of our knowledge, this is the first reported case of erlotinib-induced trichomegaly in a Chinese patient.