Successful Treatment of Epidermal Growth Factor Receptor Inhibitor-Induced Alopecia with Doxycycline

July 2015 in “ JAAD Case Reports ”

Chen Chen, Daniel B. Costa, Peggy A. Wu

epidermal growth factor receptor inhibitor EGFR inhibitor erlotinib alopecia doxycycline corticosteroid-resistant alopecia non-small cell lung cancer anti-inflammatory antibiotic hair loss steroid-resistant hair loss

TLDR Doxycycline can effectively treat hair loss caused by EGFR inhibitors.

A 77-year-old woman with non-small cell lung cancer developed alopecia after starting the EGFR inhibitor erlotinib, which was unresponsive to traditional corticosteroid treatments. The patient experienced significant improvement in her alopecia, including partial hair regrowth and resolution of crusting, after being treated with oral doxycycline (100 mg twice daily for 6 weeks, then 50 mg twice daily for 4.5 months). The positive effects were maintained for over 3 months after discontinuation of doxycycline, allowing her to continue erlotinib without dosage changes. This case suggested that doxycycline, due to its anti-inflammatory and antibiotic properties, could be a potential treatment for corticosteroid-resistant EGFR inhibitor–induced alopecia.

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research Erosive Pustular Dermatosis of the Scalp-Like Eruption due to Gefitinib: Case Report and Review of the Literature of Alopecia Associated with EGFR Inhibitors

36 citations, January 2012 in “Dermatology”

A 69-year-old Japanese woman with non-small-cell lung cancer developed erythematous erosive alopecia with pustules on the scalp after three years of gefitinib treatment. A biopsy revealed dense perifollicular infiltration, and methicillin-resistant Staphylococcus aureus was cultured from the lesions, but antibiotics were ineffective. The condition, resembling erosive pustular dermatosis of the scalp, improved rapidly after discontinuing gefitinib. Including this case, there were 11 reported cases of alopecia associated with EGFR inhibitors, all in females, primarily affecting the parietal scalp, and requiring reduction or discontinuation of the inhibitors, resulting in scarring alopecia.

research Effective Treatment of Folliculitis Decalvans Using Selected Antimicrobial Agents

33 citations, January 2010 in “International journal of trichology”

Antimicrobial therapy can help manage Folliculitis Decalvans.

research Classification and Management of Skin, Hair, Nail, and Mucosal Side Effects of Epidermal Growth Factor Receptor Inhibitors

138 citations, March 2007 in “European journal of cancer”

EGFR inhibitors often cause skin problems and other side effects, but these are usually reversible and can be managed to keep patients comfortable.