Risk of Distinctive Hair Changes Associated With Pazopanib in Patients With Renal Cell Carcinoma (RCC) Versus Patients Without RCC: A Comparative Systematic Review and Meta-analysis

The Cellular Stress and Cutaneous Manifestations in Renal Cell Carcinomas—A Narrative Review

“…Potential pathogenic mechanisms include drug-induced neoantigen formation, unmasking of usually hidden autoantigens, and generalized activation of CD4+ and CD8+ T cells, leading to diffuse keratinocyte apoptosis [121]. Cutaneous immune-related adverse events induced by immune checkpoint inhibitors can be grouped as follows: (a) inflammatory dermatoses (maculopapular eruptions) and papulosquamous disorders (pityriasis rosea, pityriasis lichenoides, pityriasis rubra pilaris, lichenoid and psoriasiform lesions); (b) immune bullous dermatoses (bullous pemphigoid, linear IgA dermatosis); (c) melanocyte alterations (vitiligo-like skin depigmentation, tumoral melanosis and regression of melanocytic nevi, poliosis, and eyebrow or eyelash depigmentation); (d) keratinocyte alterations (benign, precancerous, and cancerous keratinocytic lesions, mainly on photodamaged skin, seborrheic keratoses, actinic keratoses, keratoacanthomas, basal or squamous cell carcinomas); (e) hair abnormalities (non-scarring alopecia, partial or diffuse alopecia areata, hypotrichosis, vi-tiligo, universal alopecia, hair texture changes); (f) nail involvement (nail dystrophy, mostly with psoriasiform or lichenoid features, onychomadesis and proximal onychoschizia, diffuse onycholysis and paronychia); (g) oral involvement (mucositis, gingivitis, xerostomia, dysgeusia, Sjogren syndrome); and (h) rare reactions (photosensitivity, dermatomyositis, panniculitis, granulomatous dermatitis, lymphomatoid or eosinophilic cutaneous toxicity, acute generalized exanthematous pustulosis, neutrophilic dermatoses, toxic epidermal necrolysis) [22,121,[130][131][132].…”

Reversible hypopigmentation with pazopanib

“…[8] Vega et al, [7] has reported two Mexican patients with synovial sarcoma, developed hypopigmentation on treatment with Pazopanib. Various phase I and phase II randomized clinical trials [9] in renal cell carcinoma, [10] nonsmall cell lung cancer, [11] and breast [12] cancer treated with Pazopanib have reported all grade hair color changes in 109 (38%), 4 (6.6%), and 14 (18%) patients, respectively. This is one of the clinical case reports to make aware about this side effect of Pazopanib to the treating oncologist.…”