Erlotinib-Associated Alopecia in a Lung Cancer Patient

In this case study, a 74-year-old patient with metastatic non-small cell lung cancer (NSCLC) developed severe alopecia after switching from gefitinib to erlotinib, both epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). While gefitinib treatment resulted in only mild skin toxicity, erlotinib led to a grade 2 follicular rash and significant hair loss, with most scalp hair falling out by the 16th week of therapy. The hair loss pattern was more pronounced than typically reported with EGFR-targeted therapies. Despite continued erlotinib use, new hair growth was observed, suggesting that the alopecia was not permanent. The findings supported the role of EGFR in hair growth regulation, as EGFR inhibition can disrupt the hair cycle, leading to hair loss.