Advertisement

American Journal of Clinical Dermatology

, Volume 12, Issue 1, pp 63–67 | Cite as

Cetuximab-Associated Elongation of the Eyelashes

Case Report and Review of Eyelash Trichomegaly Secondary to Epidermal Growth Factor Receptor Inhibitors
  • Philip R. CohenEmail author
  • Susan M. Escudier
  • Razelle Kurzrock
Case Reports Cetuximab-Associated Eyelash Trichomegaly

Abstract

Eyelash trichomegaly is an uncommon drug-associated sequelae experienced during treatment with epidermal growth factor receptor (EGFR) inhibitors. Elongation of the eyelashes induced by these agents has predominantly been observed in oncology patients with either colorectal or lung cancer. It is most frequently associated with cetuximab and erlotinib; however, it has also been described in individuals treated with gefitinib or panitumumab. We describe cetuximab-associated eyelash trichomegaly in a woman with metastatic rectal carcinoma. We review the clinical presentation, adverse effects, and management of EGFR inhibitor-related eyelash trichomegaly. The long eyelashes are not a drug-limiting adverse effect and some patients consider the change to be cosmetically enhancing. Trimming the lashes with scissors can usually ameliorate local symptoms. The eyelashes often return to their original length at variable time periods after EGFR inhibitor therapy is discontinued.

Keywords

Epidermal Growth Factor Receptor Irinotecan Cetuximab Gefitinib Erlotinib 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

No sources of funding were used to prepare this case report. The authors have no conflicts of interest that are directly relevant to the content of this case report.

References

  1. 1.
    Melichar B, Nemcova I. Eye complications of cetuximab therapy. Eur J Cancer Care 2007; 16: 439–43CrossRefGoogle Scholar
  2. 2.
    Foerster CG, Cursiefen C, Kruse FE. Persisting corneal erosion under cetuximab (erbitux) treatment (epidermal growth factor receptor antibody). Cornea 2008; 27: 612–4PubMedCrossRefGoogle Scholar
  3. 3.
    Vano-Galvan S, Moreno-Martin P, Jaen P. Progressive trichomegaly [photo quiz]. Neth J Med 2009; 67: 35–6PubMedGoogle Scholar
  4. 4.
    Bouche O, Brixi-Benmansour H, Bertin A, et al. Trichomegaly of the eyelashes following treatment with cetuximab. Ann Oncol 2005; 16: 1711–2PubMedCrossRefGoogle Scholar
  5. 5.
    Osio A, Mateus C, Soria JC, et al. Cutaneous side-effects in patients on longterm treatment with epidermal growth factor receptor inhibitors. Br J Dermatol 2009; 161: 515–21PubMedCrossRefGoogle Scholar
  6. 6.
    Marquez G, Herrera-Acosta E, Vidal I, et al. A case of trichomegaly of the eyelashes and facial hypertrichosis induced by erlotinib (tarceva) [letter]. Int J Dermatol 2009; 48: 97–8PubMedCrossRefGoogle Scholar
  7. 7.
    Lacouture ME, Boerner SA, Lo Russo PM. Non-rash skin toxicities associated with novel targeted therapies. Clin Lung Cancer 2006; 8 Suppl. 1: S36–42CrossRefGoogle Scholar
  8. 8.
    Mitchell EP, Perez-Soler R, Van Cutsem E, et al. Clinical presentation and pathophysiology of EGFRI dermatologic toxicities. Oncology 2007; 21 (11 Suppl. 5): 4–9PubMedGoogle Scholar
  9. 9.
    Morse L, Calarese P. EGFR-targeted therapy and related skin toxicity. Semin Oncol Nursing 2006; 22: 152–62CrossRefGoogle Scholar
  10. 10.
    Lacouture ME. Mechanisms of cutaneous toxicities to EGFR inhibitors. Nat Rev Cancer 2006; 6: 803–12PubMedCrossRefGoogle Scholar
  11. 11.
    Robert C, Soria J-C, Spatz A, et al. Cutaneous side-effects of kinase inhibitors and blocking antibodies. Lancet Oncol 2005; 6: 491–500PubMedCrossRefGoogle Scholar
  12. 12.
    Lacouture ME, Melosky BL. Cutaneous reactions to anticancer agents targeting the epidermal growth factor receptor: a dermatology-oncology perspective. Skin Ther Lett 2007; 12 (6): 1–5Google Scholar
  13. 13.
    Bovenschen HJ, Hans Alkemade JAC. Erlotinib-induced dermatologic sideeffects [letter]. Int J Dermatol 2009; 48: 326–8PubMedCrossRefGoogle Scholar
  14. 14.
    Deslandres M, Sibaud V, Chevreau C, et al. Cutaneous side effects associated with epidermal growth factor receptor and tyrosine kinase inhibitors [in French]. Annales Dermatologie 2008; 1: 16–24Google Scholar
  15. 15.
    Agero ALC, Dusza SW, Benvenuto-Andrade C, et al. Dermatologic side effects associated with the epidermal growth factor receptor inhibitors. J Am Acad Dermatol 2006; 55: 657–70PubMedCrossRefGoogle Scholar
  16. 16.
    Segaert S, Van Cutsem E. Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors. Ann Oncol 2005; 16: 1425–33PubMedCrossRefGoogle Scholar
  17. 17.
    Graves JE, Jones BF, Lind AC, et al. Nonscarring inflammatory alopecia associated with the epidermal growth factor receptor inhibitor gefitinib. J Am Acad Dermatol 2006; 55: 349–53PubMedCrossRefGoogle Scholar
  18. 18.
    Cowen EW. Epidermal growth factor receptor inhibitors: a new era of drug reactions in a new era of cancer therapy. J Am Acad Dermatol 2007; 56: 514–7PubMedCrossRefGoogle Scholar
  19. 19.
    Zhang G, Basti S, Jampol LM. Acquired trichomegaly and symptomatic external ocular changes in patients receiving epidermal growth factor receptor inhibitors: case reports and a review of literature. Cornea 2007; 26: 858–60PubMedCrossRefGoogle Scholar
  20. 20.
    Monti M, Motta S. Clinical management of cutaneous toxicity of anti-EGFR agents. Int J Biol Markers 2007; 22 Suppl. 4: S53–61Google Scholar
  21. 21.
    Busam KJ, Capodieci P, Motzer R, et al. Cutaneous side-effects in cancer patients treated with the epidermal growth factor receptor antibody C225. Br J Dermatol 2001; 144: 1169–76PubMedCrossRefGoogle Scholar
  22. 22.
    Shah NT, Kris MG, Pao W, et al. Practical management of patients with nonsmall- cell lung cancer treated with gefitinib. J Clin Oncol 2005; 23: 165–74PubMedCrossRefGoogle Scholar
  23. 23.
    Lacouture ME, Lai SE. The PRIDE (papulopustules and/or paronychia, regulatory abnormalities of hair growth, itching, and dryness due to epidermal growth factor receptor inhibitors) syndrome [letter]. Br J Dermatol 2006; 155: 852–54PubMedCrossRefGoogle Scholar
  24. 24.
    Roe E, Muret MPG, Marcuello E, et al. Description and management of cutaneous side effects during cetuximab or erlotinib treatments: a prospective study of 30 patients. J Am Acad Dermatol 2006; 55: 429–37PubMedCrossRefGoogle Scholar
  25. 25.
    Drelich DA, Rose L, Ramirez M, et al. Dermatological toxicities of panitumumab in the treatment of patients with metastatic colorectal cancer (mCRC) from three clinical studies [abstract no. 14551]. JClin Oncol 2007 Jun 20; 25 (18 Suppl.): 629sGoogle Scholar
  26. 26.
    Van Doorn R, Kirtschig G, Scheffer E, et al. Follicular and epidermal alternations in patients treated with ZD1839 (Iressa), an inhibitor of the epidermal growth factor receptor. Br J Dermatol 2002; 147: 598–601PubMedCrossRefGoogle Scholar
  27. 27.
    Basti S. Ocular toxicities of epidermal growth factor receptor inhibitors and their management. Cancer Nurs 2007; 30 (4 Suppl. 1): S10–6CrossRefGoogle Scholar
  28. 28.
    Garibaldi DC, Adler RA. Cicatricial ectropion associated with treatment of metastatic colorectal cancer with cetuximab. Ophthal Plast Reconstr Surg 2007; 23: 62–3PubMedCrossRefGoogle Scholar
  29. 29.
    Methvin AB, Gausas RE. Newly recognized ocular side effects of erlotinib. Ophthal Plast Reconstr Surg 2007; 23: 63–5PubMedCrossRefGoogle Scholar
  30. 30.
    Lacouture ME, Basti S, Patel J, et al. The SERIES clinic: an interdisciplinary approach to the management of toxicities of EGFR inhibitors. J Support Oncol 2006; 4: 236–8PubMedGoogle Scholar
  31. 31.
    Alexandrescu DT, Kauffman CL, Dasanu CA. Persistent hair growth during treatment with EGFR inhibitor erlotinib. Dermatol Online J 2009; 15 (3): 4PubMedGoogle Scholar
  32. 32.
    Carser JE, Summers YJ. Trichomegaly of the eyelashes after treatment with erlotinib in non-small cell lung cancer. J Thorac Oncol 2006; 1: 1040–1PubMedCrossRefGoogle Scholar
  33. 33.
    Braiteh F, Kurzrock R, Johnson FM. Trichomegaly of the eyelashes after lung cancer treatment with the epidermal growth factor receptor inhibitor erlotinib. J Clin Oncol 2008; 26: 3460–2PubMedCrossRefGoogle Scholar
  34. 34.
    Lane K, Goldstein SM. Erlotinib-associated trichomegaly. Ophthal Plast Reconstr Surg 2007; 23: 65–6PubMedCrossRefGoogle Scholar
  35. 35.
    Papadopoulos R, Chasapi V, Bachariou A. Trichomegaly induced by erlotinib. Orbit 2008; 35: 329–30CrossRefGoogle Scholar
  36. 36.
    Vaccaro M, Pollicino A, Barbuzza O, et al. Trichomegaly of the eyelashes following treatment with cetuximab. Clin Exp Dermatol 2008; 34: 402–3PubMedCrossRefGoogle Scholar
  37. 37.
    Bagazgoitia L, Aboin S, Bea A, et al. Trichomegaly due to cetuximab. Med Clin (Barc) 2009; 133: 323CrossRefGoogle Scholar
  38. 38.
    Dueland S, Sauer T, Lund-Johansen F, et al. Epidermal growth factor receptor inhibition induces trichomegaly. Acta Oncologica 2003; 42: 345–6PubMedCrossRefGoogle Scholar
  39. 39.
    Hilton L. Skin ‘walking wounded’ of cancer tx: anticipating, treating cutaneous side effects keys to quality of life, compliance. Dermatology Times 2007 Mar 1; 28 [online]. Available from URL: (http://license.icopyright.net/user/viewFreeUse.act?fuid=NDIzMzM2Mw%3D%3D) [Accessed 2009 Jul 23]
  40. 40.
    Kerob D, Dupuy A, Reygagne P, et al. Facial hypertrichosis induced by cetuximab, an anti-EGFR monoclonal antibody. Arch Dermatol 2006; 142: 1656–7PubMedCrossRefGoogle Scholar
  41. 41.
    Hu JC, Sadeghi P, Pinter-Brown LC, et al. Cutaneous side effects of epidermal growth factor receptor inhibitors: clinical presentation, pathogenesis, and management. J Am Acad Dermatol 2007; 56: 317–26PubMedCrossRefGoogle Scholar
  42. 42.
    Pascual JC, Banuls J, Belinchon I, et al. Trichomegaly following treatment with gefitinib (ZD1839) [letter]. Br J Dermatol 2004; 151: 1111–2PubMedCrossRefGoogle Scholar
  43. 43.
    Montagut C, Grau JJ, Grimalt R, et al. Abnormal hair growth in a patient with head and neck cancer treated with the anti-epidermal growth factor receptor monoclonal antibody cetuximab. J Clin Oncol 2005; 23: 5273–5PubMedCrossRefGoogle Scholar
  44. 44.
    Cohen EEW, Rosen F, Stadler WM, et al. Phase II trial of ZD1839 in recurrent or metastatic squamous cell carcinoma of the head and neck. J Clin Oncol 2003; 21: 1980–7PubMedCrossRefGoogle Scholar
  45. 45.
    Siegel-Lakhai WS, Beijnen JH, Schellens JH. Current knowledge and future directions of the selective epidermal growth factor receptor inhibitors erlotinib (Tarceva) and gefitinib (Iressa). Oncologist 2005; 10: 579–89PubMedCrossRefGoogle Scholar
  46. 46.
    Murillas R, Larcher F, Conti CJ, et al. Expresssion of a dominant negative mutant of epidermal growth factor receptor in the epidermis of transgenic mice elicits striking alterations in hair follicle development and skin structure. EMBO J 1995; 14: 5216–23PubMedGoogle Scholar
  47. 47.
    Nanney LB, Stoscheck CM, King Jr LE, et al. Immunolocalization of epidermal growth factor receptors in normal developing human skin. J Invest Dermatol 1990; 94: 742–8PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2011

Authors and Affiliations

  • Philip R. Cohen
    • 1
    • 2
    • 3
    Email author
  • Susan M. Escudier
    • 4
  • Razelle Kurzrock
    • 5
  1. 1.The University of Houston Health CenterUniversity of HoustonHoustonUSA
  2. 2.Department of DermatologyUniversity of Texas-Houston Medical SchoolHoustonUSA
  3. 3.Department of DermatologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  4. 4.Texas Oncology P.A.HoustonUSA
  5. 5.Department of Clinical Therapeutics (a Phase I Program)The University of Texas MD Anderson Cancer CenterHoustonUSA

Personalised recommendations