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2026, Number 1

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Dermatología Cosmética, Médica y Quirúrgica 2026; 24 (1)

Trichoscopic findings associated with afatinib therapy in non-small cell lung cancer: a case series and review of the literature

Vega-Gonzalez MT, Asz-Sigall D, Barrera-Ochoa C, Rodarte-Acosta JS, Bujanda-Sandoval DA, Cruz-Quiñones MF, Courvoisier-Noriega CC

Language: Spanish
References: 17
Page: 29-35
PDF size: 313.41 Kb.


ABSTRACT

INTRODUCTION: Afatinib is an irreversible inhibitor of the epidermal growth factor receptor (EGFR), associated with a high frequency of cutaneous adverse effects, including trichological alterations. However, the description of these changes using trichoscopy is limited.
OBJECTIVE: To describe the trichoscopic findings associated with the use of afatinib in patients with non-small cell lung cancer (NSCLC).
METHODS: A descriptive observational case series study was conducted in adult patients with NSCLC treated with afatinib. A trichological evaluation was performed, documenting hair shaft alterations, perifollicular changes, and follicular patterns.
RESULTS: Four female patients were included. Trichological manifestations began in the second week after starting afatinib. Findings included perifollicular erythema and hyperkeratosis, absence of follicular openings, white spots, perifollicular pustules, and structural alterations of the hair shaft consistent with pili torti, as well as hypertrichosis and trichomegaly of the eyelashes.
CONCLUSIONS: Afatinib is associated with trichological adverse events, some with possible inflammatory and scarring involvement. Trichoscopy is a useful tool for the early identification and monitoring of structural changes in the hair shaft.


REFERENCES

  1. Cabrera-Miranda LA, Díaz-García DA, José FranciscoCorona-Cruz, Lozano-Ruiz FJ, Sánchez-Reyes R, Álvarez-Bojórquez ME, et al. Guía de práctica clínica para el manejo delcáncer de pulmón de células pequeñas: enfermedad extensa.Gaceta Mexicana de Oncología. 2023 Jun 30;22(2). Disponibleen: https://doi.org/10.24875/j.gamo.22000122

  2. Smolarz B, Łukasiewicz H, Samulak D, Piekarska E, KołacińskiR, Romanowicz H. Lung Cancer-Epidemiology, Pathogenesis,Treatment and Molecular Aspect (Review of Literature).International journal of molecular sciences [Internet]. 2025 Feb26;26(5):2049. Disponible en: https://pubmed.ncbi.nlm.nih.gov/40076671/

  3. Ortega, M. A., Pekarek, L., Navarro, F., Fraile-Martínez, O.,García-Montero, C., Álvarez-Mon, M. Á., Diez-Pedrero, R.,Boyano-Adánez, M. d. C., Guijarro, L. G., Barrena-Blázquez, S.,Gómez-Lahoz, A. M., Haro, S., Arroyo, M., Monserrat, J., Saez,M. A., & Alvarez-Mon, M. . Updated Views in Targeted Therapyin the Patient with Non-Small Cell Lung Cancer. Journal ofPersonalized Medicine. 2023, 13(2), 167. Disponible en: https://doi.org/10.3390/jpm13020167

  4. Tsaqilah, L., Putri, A. D., & Avriyanti, E. (2025). DermatologicAdverse Events Following Afatinib in a Woman withNon-Small-Cell Lung Cancer: A Case Report. Clinical, cosmeticand investigational dermatology, 18, 151–159. Disponible en:https://doi.org/10.2147/CCID.S490820

  5. Smolarz, B., Łukasiewicz, H., Samulak, D., Piekarska, E.,Kołaciński, R., & Romanowicz, H. Lung Cancer—Epidemiology,Pathogenesis, Treatment and Molecular Aspect (Reviewof Literature). International Journal of Molecular Sciences.2025, 26(5), 2049. Disponible en: https://doi.org/10.3390/ijms26052049

  6. Dan, H., Jiang, Q., Jia, X., Qi, G., Zong, D., & Li, Z.,Dermatologic toxicities in epidermal growth factor receptor:a comprehensive pharmacovigilance study from 2013 to2023. Frontiers in medicine. 2024; 10. https://doi.org/10.3389/fmed.2023.1283807

  7. Macdonald JB, Macdonald B, Golitz LE, LoRusso P, SekulicA. Cutaneous adverse effects of targeted therapies: PartI: Inhibitors of the cellular membrane. J Am Acad Dermatol.2015;72(2):203-220. Disponible en: https://doi.org/10.1016/j.jaad.2014.07.032.

  8. Wecker H, Waller CF. Afatinib. Recent Results Cancer Res.2018;211:199-215. Disponible en: https://doi.org/10.1007/978-3-319-91442-8_14.

  9. J.F. Mir-Bonafé, D. Saceda-Corralo, S. Vañó-Galván, AdverseHair Reactions to New Targeted Therapies for Cancer, ActasDermo-Sifiliográficas (English Edition), 2019; 110(3); 182-192.Disponible en: https://doi.org/10.1016/j.adengl.2019.02.017.

  10. Chanprapaph K, Pongcharoen P, Vachiramon V. Cutaneousadverse events of epidermal growth factor receptor inhibitors:A retrospective review of 99 cases. Indian journal ofdermatology, venereology and leprology. 2015;81(5):547. DOI:10.4103/0378-6323.157448. PMID: 25994883.

  11. Kozuki T. Skin problems and EGFR-tyrosine kinase inhibitor. JpnJ Clin Oncol. 2016;46(4):291-298. Disponible en: https://doi.org/10.1093/jjco/hyv207. Epub 2016 Jan 29. PMID: 26826719;PMCID: PMC488613

  12. Huang J, Meng L, Yang B, Sun S, Luo Z, Chen H. SafetyProfile of Epidermal Growth Factor Receptor Tyrosine KinaseInhibitors: A Disproportionality Analysis of FDA Adverse EventReporting System. Scientific reports, 10(1), 4803. Disponibleen: https://doi.org/10.1038/s41598-020-61571-5

  13. Giuseppe Giaccone. Epidermal Growth Factor ReceptorInhibitors in the Treatment of Non–Small-Cell Lung Cancer. JClin Oncol. 2005; 23, 3235-3242. Disponible en: https://doi.org/10.1200/JCO.2005.08.409

  14. Nowaczyk, J., Fret, K., Kaminska-Winciorek, G., Rudnicka, L.,& Czuwara, J. EGFR inhibitor-induced folliculitis decalvans: acase series and management guidelines. Anti-cancer drugs;2023; 34(8), 942-948. Disponible en: https://doi.org/10.1097/CAD.0000000000001494

  15. Kremer N, Martinez H, Leshem YA, Hodak E, Zer A, Brenner B,et al. The trichoscopic features of hair shaft anomalies inducedby epidermal growth factor receptor inhibitors: A case series.Journal of the American Academy of Dermatology [Internet].2021 Nov;85(5):1178–84. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32244022

  16. Mir-Bonafé JF, Saceda-Corralo D, Vañó-Galván S. Adverse HairReactions to New Targeted Therapies for Cancer. Reaccionescapilares de las nuevas terapias diana dirigidas contra el cáncer.Actas dermo-sifiliográficas, 2019; 110(3), 182–192. Disponibleen: https://doi.org/10.1016/j.ad.2018.10.019

  17. Nowaczyk J, Fret K, Kaminska-Winciorek G, Rudnicka L,Czuwara J. EGFR inhibitor-induced folliculitis decalvans: a caseseries and management guidelines. Anti-Cancer Drugs. 2023Jan 24;34(8):942–8. Disponible en: https://doi.org/10.1097/CAD.0000000000001494




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