Trichomegaly and scalp hair changes following treatment with erlotinib in pulmonary adenocarcinoma patients: A case report and literature review

The past decades have witnessed a rapid increase in the use of molecularly targeted therapies. One class of agents includes the epidermal growth factor receptor inhibitors (EGFRIs), which afford patients longer progression-free survival (PFS) times, especially among non-small cell lung cancer (NSCLC) and metastatic colorectal carcinoma (mCRC). Certain adverse effects, particularly skin toxicity, are mainly manifested as rash, xerosis, pruritus, nails changes, hair changes and mucositis. Previous studies reported the adverse events occurred based on the cutaneous inflammation reaction. Treatment recommended glucocorticoids and antibiotics. It is suggested that skin toxicity is an important issue because it usually affects patients' quality of life (QoL) and still causes dose reduction or discontinuation of targeted therapies. For these reasons, more and more oncologists and dermatologists recognize the importance of recognition and management of skin toxicities with the expansion in availability of EGFRIs. In this review, we conducted a systematic review of recent data to examine the types and frequencies of dermatologic toxicities associated with anti-epidermal growth factor receptor (EGFR) therapies in NSCLC and mCRC. In addition, we would like to explore the management and treatment options currently used by clinicians based on the possible mechanism.

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“…Grade 3 (49). Excessive hypertrichosis also included of the face (50). The appearance of eyelash change is presented in Figure 5.…”

Section: Grade 1 Gradementioning

confidence: 99%

Update review of skin adverse events during treatment of lung cancer and colorectal carcinoma with epidermal growth receptor factor inhibitors

Peng

Zhang

et al. 2018

BST

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“…However, change of hair texture from curly to straight hair has been described after the treatment of hepatitis C virus infection and alopecia. 19 20 Inhibition or mutation of the epidermal growth factor receptor has been reported to change the hair texture and causing eyelash trichomegaly 21 In adults, a change of hair texture occurs very rarely, and causes are unrelated to Horner's syndrome. We report the rare case of an infant in whom Horner's syndrome occurred after surgical resection of a giant lymphangioma of the neck region.…”

Section: Discussionmentioning

confidence: 99%

Unilateral Straight Hair—A Symptom of Acquired Horner's Syndrome in a Neonate

Ott

Bobylev

Holland‐Cunz

et al. 2018

European J Pediatr Surg Rep

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A multicystic tumor of the right neck was detected in a girl at 29 weeks of gestation by fetal ultrasound and magnetic resonance imaging (MRI). The baby was delivered by cesarean section at week 37 of gestation. The newborn adapted well, with minimal compromise of breathing and drinking. Postnatal ultrasound and MRI revealed a cervical lymphangioma measuring 60.5 × 60.6 × 41.2 mm. We performed subtotal resection of the tumor when the girl was 34 days. As a complication of surgical resection, the girl developed ipsilateral Horner's syndrome. In the postoperative period, her curled hair turned straight at the side of the head affected by Horner's syndrome. At the age of 2.5 years, ultrasonic imaging revealed the presence of three cysts measuring 3 mm in diameter each. Horner's syndrome had improved, and the texture of the girl's hair had become curly again on both sides.

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“…В зависимости от тяжести проявлений патологии ногтевой пластины (G1-G3) могут быть использованы топические и системные антибактериальные средства, системные ретиноиды (изотретиноин, ацитретин), противогрибковые ЛС, противовирусные ЛС. Изменение волос на фоне терапии EGFR-TKIингибиторами может сопровождаться нарушением структуры, толщины (истончение), цвета как длинных (волосы скальпа), так и коротких волос (ресницы, брови); выпадение волос (алопеция) встречается у 1,9-4,9% пациентов; в некоторых случаях фиксируют развитие лицевого гипертрихоза [8][9][10]. Мукозиты чаще развиваются на слизистых оболочках полости рта, проявляются набуханием эпителия, формированием признаков ульцерации; болевые ощущения при этом обычно выражены в значительной степени, нарушают прием пищи и даже воды.…”

Section: резюме _____________________________________________________...unclassified

Targeted Treatments of Non-Small Cell Lung Cancer (NSCLC): Skin Toxicity

Лукьянов¹

2022

Дерматовенерология Косметология

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Молекулярно-таргетная терапия (МТТ) – стремительно развивающаяся область современной медицины вообще и онкологии в частности. С появлением некоторых классов биологических агентов, например таких как ингибиторы рецепторов эпидермального фактора роста (EGFRI – Epidermal Growth Factor Receptor Inhibitors), стало возможным обеспечивать пациентам более длительную выживаемость без прогрессирования, особенно при немелкоклеточном раке легкого (НМРЛ) и метастатической колоректальной карциноме. По данным Белорусского канцер-регистра, за последние 10 лет (2010–2019 гг.) среди мужского населения страны рак легкого вышел на первое место [32]. В этой связи все чаще в терапии НМРЛ стали применять МТТ. Побочные эффекты при использовании таких препаратов обычно минимальны с точки зрения частоты и тяжести. Вместе с тем применение EGFRI в большинстве случаев приводит к развитию кожной токсичности, которая при использовании традиционной химиотерапии и лучевой терапии встречается реже, а ее тяжесть значительно меньше выражена. Дерматотропные побочные эффекты после старта МТТ могут возникать в 47–100%, ксероз – в 10–49%, кожный зуд – в 8–57%, паронихии – в 3–25%, аномалии роста волос – в 0–13%, мукозиты – в 0–44% случаев [33]. При этом следует отметить, что кожная токсичность чаще возникает на фоне применения моноклональных антител, чем при назначении ингибиторов тирозинкиназы.В статье подробно разобраны вопросы классификации кожной токсичности у пациентов, проходящих МТТ. Описаны клинические варианты наиболее часто фиксируемых побочных дерматотропных эффектов, время их развития относительно старта терапии. Приведены инструменты, с помощью которых клиницист может оценить влияние кожной токсичности на показатели качества жизни у пациентов, получающих таргеты. Отдельное внимание уделено общим вопросам ухода за кожей, а также медикаментозного сопровождения кожной токсичности у таких пациентов. Материал содержит клинические примеры из собственной практики автора. Molecularly targeted therapy (MTT) is a rapidly developing area of oncology and modern medicine in general. With the advent of certain classes of biological agents, such as Epidermal Growth Factor Receptor Inhibitors (EGFRIs), it has become possible to provide patients with longer progression-free survival, especially in non-small cell lung cancer (NSCLC) and metastatic colorectal carcinoma. According to the Belarusian Cancer Registry, over the past 10 years (2010–2019), lung cancer has come out on top among the male population of the country [32]. In this regard, MTT has been increasingly used in the treatment of NSCLC. Side effects with these drugs are usually minimal in terms of frequency and severity. However, the use of EGFRI in most cases leads to the development of skin toxicity, which is less common with traditional chemotherapy and radiation therapy, and its severity is much less pronounced. Dermatotropic side effects after starting MTT can occur in 47–100%, xerosis cutis – in 10–49%, pruritus – in 8–57%, paronychia – in 3–25%, hair growth abnormalities – in 0–13%, mucositis – in 0–44% of cases [33]. It should be noted that skin toxicity occurs more often with the use of monoclonal antibodies than with the use of tyrosine kinase inhibitors.This article deals in detail with the classification of skin toxicity in patients undergoing MTT. The clinical variants of the most frequently recorded dermatotropic side effects and the time of their development relative to the start of therapy are described. The tools are presented with which the clinician can evaluate the impact of dermal toxicity on quality of life indicators in patients receiving targeted therapy. Special attention is paid to general issues of skin care, as well as drug management of skin toxicity in such patients. The material contains clinical examples from the author’s own practice.

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Trichomegaly and scalp hair changes following treatment with erlotinib in pulmonary adenocarcinoma patients: A case report and literature review

Cited by 14 publications

References 36 publications

Update review of skin adverse events during treatment of lung cancer and colorectal carcinoma with epidermal growth receptor factor inhibitors

Update review of skin adverse events during treatment of lung cancer and colorectal carcinoma with epidermal growth receptor factor inhibitors

Unilateral Straight Hair—A Symptom of Acquired Horner's Syndrome in a Neonate

Targeted Treatments of Non-Small Cell Lung Cancer (NSCLC): Skin Toxicity

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