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A 55-year-old woman with metastatic lung cancer was treated with erlotinib, a tyrosine kinase inhibitor of the epidermal growth factor receptor. Cutaneous toxic effects are specific to this class of agents and are associated with an improved clinical outcome. One week after the initial administration of erlotinib, a characteristic facial papulopustular eruption developed, sparing the orbital region. Three months later, typical hair alterations developed (Panels A and B). The brows and lashes darkened and displayed increased thickness (trichomegaly), curling, and elongation, accompanied by increased hair fragility (trichorrhexis). After the initial response to treatment, the patient had progression of the tumor, and erlotinib therapy was discontinued. Three months later, the hair alterations resolved. Hair alterations are reversible months after discontinuation of therapy inhibiting the epidermal growth factor receptor.
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