Gefitinib
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Gefitinib Scarring alopecia in an elderly patient: case report A 70-year-old woman with non-small cell lung cancer developed scarring alopecia during treatment with gefitinib. The woman started receiving gefitinib [Iressa] 250 mg/day and, after 2 months, she developed hair textural changes and slower hair growth. Eight months after drug start, she developed scalp erythema and crusting that progressed to scarring alopecia. She presented about 2 years after reaction onset for evaluation of the eruption. Punch biopsy specimen from an erythematous scaly region on the scalp vertex revealed parakeratosis and focal follicular plugging that contained neutrophils. She also had superficial dermal oedema, and a chronic inflammatory infiltration of mainly plasma cells with some lymphocytes distributed in the dermis. The upper part of the hair follicles were obscured by fibrosis, which was compatible with scarring. Trichrome-Masson stain showed abundant collagen. Mature anagen hairs in subcutaneous fat were surrounded by plasma cells, lymphocytes, eosinophils and neutrophils. Shortly after the woman underwent the scalp biopsy, gefitinib was withdrawn due to her rapidly progressive disease, but the effects of discontinuing drug on hair regrowth could not be assessed because, 2 weeks later, she died of widespread metastatic disease. Author comment: "The rapid acquisition of hair textural changes along the histopathological characteristics of the present case favored a diagnosis of scarring alopecia secondary to gefitinib." Donovan JC, et al. Scarring alopecia associated with use of the epidermal growth factor receptor inhibitor gefitinib. Archives of Dermatology 144: 1524-1525, No. 801118777 11, Nov 2008 - Canada
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Reactions 29 Nov 2008 No. 1230
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