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Cetuximab-Associated Elongation of the Eyelashes

Case Report and Review of Eyelash Trichomegaly Secondary to Epidermal Growth Factor Receptor Inhibitors

  • Case Reports
  • Cetuximab-Associated Eyelash Trichomegaly
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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.

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References

  1. Melichar B, Nemcova I. Eye complications of cetuximab therapy. Eur J Cancer Care 2007; 16: 439–43

    Article  CAS  Google Scholar 

  2. Foerster CG, Cursiefen C, Kruse FE. Persisting corneal erosion under cetuximab (erbitux) treatment (epidermal growth factor receptor antibody). Cornea 2008; 27: 612–4

    Article  PubMed  Google Scholar 

  3. Vano-Galvan S, Moreno-Martin P, Jaen P. Progressive trichomegaly [photo quiz]. Neth J Med 2009; 67: 35–6

    PubMed  CAS  Google Scholar 

  4. Bouche O, Brixi-Benmansour H, Bertin A, et al. Trichomegaly of the eyelashes following treatment with cetuximab. Ann Oncol 2005; 16: 1711–2

    Article  PubMed  CAS  Google Scholar 

  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: 515–21

    Article  PubMed  CAS  Google Scholar 

  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: 97–8

    Article  PubMed  Google Scholar 

  7. Lacouture ME, Boerner SA, Lo Russo PM. Non-rash skin toxicities associated with novel targeted therapies. Clin Lung Cancer 2006; 8 Suppl. 1: S36–42

    Article  Google Scholar 

  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): 4–9

    PubMed  Google Scholar 

  9. Morse L, Calarese P. EGFR-targeted therapy and related skin toxicity. Semin Oncol Nursing 2006; 22: 152–62

    Article  Google Scholar 

  10. Lacouture ME. Mechanisms of cutaneous toxicities to EGFR inhibitors. Nat Rev Cancer 2006; 6: 803–12

    Article  PubMed  CAS  Google Scholar 

  11. Robert C, Soria J-C, Spatz A, et al. Cutaneous side-effects of kinase inhibitors and blocking antibodies. Lancet Oncol 2005; 6: 491–500

    Article  PubMed  CAS  Google Scholar 

  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): 1–5

    CAS  Google Scholar 

  13. Bovenschen HJ, Hans Alkemade JAC. Erlotinib-induced dermatologic sideeffects [letter]. Int J Dermatol 2009; 48: 326–8

    Article  PubMed  Google Scholar 

  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: 16–24

    Article  Google Scholar 

  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: 657–70

    Article  PubMed  Google Scholar 

  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: 1425–33

    Article  PubMed  CAS  Google Scholar 

  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: 349–53

    Article  PubMed  Google Scholar 

  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: 514–7

    Article  PubMed  Google Scholar 

  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: 858–60

    Article  PubMed  Google Scholar 

  20. Monti M, Motta S. Clinical management of cutaneous toxicity of anti-EGFR agents. Int J Biol Markers 2007; 22 Suppl. 4: S53–61

    Article  PubMed  CAS  Google Scholar 

  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: 1169–76

    Article  PubMed  CAS  Google Scholar 

  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: 165–74

    Article  PubMed  CAS  Google Scholar 

  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: 852–54

    Article  PubMed  CAS  Google Scholar 

  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: 429–37

    Article  PubMed  Google Scholar 

  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.): 629s

  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: 598–601

    Article  PubMed  Google Scholar 

  27. Basti S. Ocular toxicities of epidermal growth factor receptor inhibitors and their management. Cancer Nurs 2007; 30 (4 Suppl. 1): S10–6

    Article  Google Scholar 

  28. Garibaldi DC, Adler RA. Cicatricial ectropion associated with treatment of metastatic colorectal cancer with cetuximab. Ophthal Plast Reconstr Surg 2007; 23: 62–3

    Article  PubMed  Google Scholar 

  29. Methvin AB, Gausas RE. Newly recognized ocular side effects of erlotinib. Ophthal Plast Reconstr Surg 2007; 23: 63–5

    Article  PubMed  Google Scholar 

  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: 236–8

    PubMed  Google Scholar 

  31. Alexandrescu DT, Kauffman CL, Dasanu CA. Persistent hair growth during treatment with EGFR inhibitor erlotinib. Dermatol Online J 2009; 15 (3): 4

    PubMed  Google Scholar 

  32. Carser JE, Summers YJ. Trichomegaly of the eyelashes after treatment with erlotinib in non-small cell lung cancer. J Thorac Oncol 2006; 1: 1040–1

    Article  PubMed  Google Scholar 

  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: 3460–2

    Article  PubMed  Google Scholar 

  34. Lane K, Goldstein SM. Erlotinib-associated trichomegaly. Ophthal Plast Reconstr Surg 2007; 23: 65–6

    Article  PubMed  Google Scholar 

  35. Papadopoulos R, Chasapi V, Bachariou A. Trichomegaly induced by erlotinib. Orbit 2008; 35: 329–30

    Article  Google Scholar 

  36. Vaccaro M, Pollicino A, Barbuzza O, et al. Trichomegaly of the eyelashes following treatment with cetuximab. Clin Exp Dermatol 2008; 34: 402–3

    Article  PubMed  Google Scholar 

  37. Bagazgoitia L, Aboin S, Bea A, et al. Trichomegaly due to cetuximab. Med Clin (Barc) 2009; 133: 323

    Article  Google Scholar 

  38. Dueland S, Sauer T, Lund-Johansen F, et al. Epidermal growth factor receptor inhibition induces trichomegaly. Acta Oncologica 2003; 42: 345–6

    Article  PubMed  Google Scholar 

  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. Kerob D, Dupuy A, Reygagne P, et al. Facial hypertrichosis induced by cetuximab, an anti-EGFR monoclonal antibody. Arch Dermatol 2006; 142: 1656–7

    Article  PubMed  Google Scholar 

  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: 317–26

    Article  PubMed  Google Scholar 

  42. Pascual JC, Banuls J, Belinchon I, et al. Trichomegaly following treatment with gefitinib (ZD1839) [letter]. Br J Dermatol 2004; 151: 1111–2

    Article  PubMed  CAS  Google Scholar 

  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: 5273–5

    Article  PubMed  Google Scholar 

  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: 1980–7

    Article  PubMed  CAS  Google Scholar 

  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: 579–89

    Article  PubMed  CAS  Google Scholar 

  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: 5216–23

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  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: 742–8

    Article  PubMed  CAS  Google Scholar 

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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.

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Authors and Affiliations

  1. The University of Houston Health Center, University of Houston, 805 Anderson Street, 77401-2806, Houston, Texas, USA

    Philip R. Cohen

  2. Department of Dermatology, University of Texas-Houston Medical School, Houston, Texas, USA

    Philip R. Cohen

  3. Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

    Philip R. Cohen

  4. Texas Oncology P.A., Houston, Texas, USA

    Susan M. Escudier

  5. Department of Clinical Therapeutics (a Phase I Program), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

    Razelle Kurzrock

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  1. Philip R. Cohen
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  2. Susan M. Escudier
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Correspondence to Philip R. Cohen.

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Cohen, P.R., Escudier, S.M. & Kurzrock, R. Cetuximab-Associated Elongation of the Eyelashes. Am J Clin Dermatol 12, 63–67 (2011). https://doi.org/10.2165/11531920-000000000-00000

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