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Published 17 March 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.09.2008.0878]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Gefitinib-induced hair alterations

Song Zheng1, Yue-long Pan1, Jiao-li Wang2, Ke-er Huang3, Ji-hong Liu1, Jian Wang1, Xue-qing Chen1

1 Department of Oncology, Hangzhou First People’s Hospital of Zhejiang Province, Hangzhou, 310006, China
2 Respiratory Department, Hangzhou First People’s Hospital of Zhejiang Province, Hangzhou, 310006, China
3 Department of Emergency, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China

Correspondence to:
Song Zheng, tztree{at}126.com

SUMMARY

Human epidermal growth factor receptor (EGFR) is an attractive target for anticancer therapy. EGFR tyrosine kinase inhibitors are generally well tolerated and do not have the severe systemic side-effects usually seen with cytotoxic drugs. A specific adverse effect common to this class of agent is a papulopustular rash, usually on the face and upper torso. During prolonged treatment with EGFR inhibitors, changes of the hairs can be noticed. This report describes a rare case of a non-small-cell lung cancer with hair changes after several months of treatment with the EGFR inhibitor gefitinib. The patient’s scalp hair grew more slowly and adopted a finer, more brittle and curly aspect. However, the eyelashes, eyebrows and hair of other parts of the face did not display similar changes. Little is known about the aetiology of this kind of hair alteration, and there are no clear evidence-based management recommendations. Histological data indicate that the hair alteration may be caused by EGFR inhibition in skin, although this has not been confirmed. Further studies are needed to investigate the reason for this phenomenon.


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