Periocular Manifestations of Afatinib Therapy

Afatinib, an epidermal growth factor receptor tyrosine kinase inhibitor used in cancer treatment, was reported to cause trichiasis, a condition where eyelashes grow abnormally and irritate the eyes, in a 67-year-old woman with spinal chordoma. After 6 months of daily Afatinib 50 mg, she experienced ocular irritation, pain, and blurred vision. Clinical examination showed trichomegaly, trichiasis, blepharitis, and corneal abrasion, along with hypertrichosis of the eyebrows. These side effects were attributed to the activation of the epidermal growth factor receptor pathway in keratinocytes, leading to hair follicle remodeling and varying severity of trichiasis.