The trichoscopic features of hair shaft anomalies induced by epidermal growth factor receptor inhibitors: A case series - 13/08/20

Doi : 10.1016/j.jaad.2020.03.055

Noa Kremer, MD ^a, Helena Martinez, MD ^a,^b, Yael Anne Leshem, MD, MCR ^a,^b, Emmilia Hodak, MD ^a,^b, Alona Zer, MD ^b,^c, Baruch Brenner, MD ^b,^c, Iris Amitay-Laish, MD ^a,^b,^⁎
^a Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
^b Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
^c Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel

^∗Correspondence to: Iris Amitay-Laish, MD, Department of Dermatology, Rabin Medical Center–Beilinson Hospital, Petach Tikva 4941492, Israel.Department of DermatologyRabin Medical Center–Beilinson HospitalPetach Tikva4941492Israel

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 13 August 2020
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Abstract

Background

Although the clinical hair changes that occur under treatment with epidermal growth factor receptor inhibitors (EGFRIs) are documented, their trichoscopic features have not been reported.

Objective

To evaluate the trichoscopic findings in scalp and facial hair, induced by EGFRI treatment.

Methods

Patients treated with EGFRIs at a tertiary oncodermatology clinic in 2015 through 2017 were evaluated for macroscopic and trichoscopic changes.

Results

The cohort included 23 patients (13 women; median age, 68 years) treated with EGFRIs for an average of 13 months (range, 2-40 months). Macroscopically, 18 patients (78%) had dry, lusterless, coarse, kinky, brittle scalp hair, and 17 (74%) had trichomegaly of the eyebrows/eyelashes. Trichoscopic findings were of hair shaft anomalies including pili torti, affecting scalp hair in 20 patients (87%), eyebrows in 6 (26%), and eyelashes in 8 (50%), and asymmetric hyperpigmented fusiform widening of hair scalp in 3 (13%), eyebrows in 10 (43%), and eyelashes in 4 (25%). Dermoscopic findings of the peri- and interfollicular skin were scale, whitish erythematous structureless areas, and branching vessels.

Limitations

Lack of trichoscopic-histologic correlation, lack of baseline examination.

Conclusion

The trichoscopic correlates of the macroscopic hair changes under EFGRI treatment include pili torti, and asymmetric hyperpigmented fusiform widening, with dermoscopic cutaneous manifestations of scale, whitish erythematous structureless areas, and branching vessels.

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Key words : asymmetric hyperpigmented fusiform widening, dermoscopy, epidermal growth factor receptor inhibitor, hair, pili torti, trichoscopy

Abbreviations used : EGF, EGFR, EGFRI, mAb, TKI

Plan

	Funding sources: None.
	Conflicts of interest: None disclosed.
	IRB approval status: Reviewed and approved by the local institutional review committee of Rabin Medical Center.
	Reprints not available from the authors.