Arrow Sign: A Rapid Microscopic Diagnosis of Hair Change Associated with Epidermal Growth Factor Receptor Inhibitors

    September 2013 in “ Journal of the American Academy of Dermatology ”
    Pai‐Shan Cheng, Feng‐Jie Lai
    TLDR A new method quickly detects hair changes from EGFR inhibitors using a microscope.
    The study reported a new rapid diagnostic method for detecting hair changes associated with epidermal growth factor receptor (EGFR) inhibitors using microscopic examination of plucked hairs. In a sample of 13 patients with stage IV lung cancer treated with gefitinib or erlotinib, a characteristic "arrow" appearance was observed in the hair root sheaths. This sign was present even in patients without visible hair loss or scalp changes. The findings suggested that EGFR inhibitors cause degeneration and fragility of hair root sheaths, and this diagnostic method could help differentiate EGFR inhibitor-related hair changes from fungal infections.
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