Scarring Alopecia Associated With the Epidermal Growth Factor Receptor Inhibitor Erlotinib

April 2011 in “ Journal of the American Academy of Dermatology ”

Donna M. Hepper, Peggy A. Wu, Milan J. Anadkat

scarring alopecia epidermal growth factor receptor EGFR erlotinib gefitinib chronic folliculitis perifollicular fibrosis

TLDR Erlotinib may cause scarring hair loss.

This document reported the first case of scarring alopecia associated with the epidermal growth factor receptor (EGFR) inhibitor erlotinib, confirmed by histopathology. A 77-year-old female with metastatic non-small cell lung cancer developed scalp erythema, pustules, and alopecia shortly after starting erlotinib therapy. Biopsy revealed chronic folliculitis and perifollicular fibrosis, consistent with scarring alopecia. Discontinuation of erlotinib led to improvement in scalp symptoms, but not significant hair regrowth. Reinitiation of erlotinib caused a recurrence of symptoms. This case suggested that scarring alopecia might be a rare class effect of systemic EGFR antagonists, including erlotinib and gefitinib.

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