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Correspondence |

Scarring Alopecia Associated With Use of the Epidermal Growth Factor Receptor Inhibitor Gefitinib

Jeffrey C. Donovan, MD, PhD; Danny M. Ghazarian, MB, ChB, PhD, FRCPC; James C. Shaw, MD, FRCPC
Arch Dermatol. 2008;144(11):1524-1525. doi:10.1001/archderm.144.11.1524.
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Follicular eruptions are well-recognized adverse effects of epidermal growth factor receptor (EGFR) inhibitor therapy.1 Although alopecia is uncommon, mice with targeted disruption of the EGFR develop alopecia.2,3 We report the development of scarring alopecia associated with use of the EGFR inhibitor gefitinib (Iressa; AstraZeneca, Mississisauga, Ontario, Canada).

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Figure 1.

A 70-year-old woman with marked frontal and vertex alopecia that appeared after the use of the epidermal growth factor receptor inhibitor gefitinib. Note the sharp demarcation of erythema at the frontal hair line and the presence of crusting (arrows).

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Figure 2.

Histologic images of punch biopsy specimens from the scalp vertex of the patient pictured in Figure 1. A, Mature anagen hairs are present in the subcutaneous fat, and loss of the superficial parts of the hair follicles is visible within the inflamed and scarred area. Note the superficial dermal edema (hematoxylin-eosin, original magnification ×50). Trichrome-Masson stain shows abundant collagen throughout the middle and deep dermis (inset) (original magnification ×20). B, High-power magnification of perifollicular infiltrate shows abundant plasma cells and fewer eosinophils and lymphocytes (hematoxylin-eosin, original magnification ×630).

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