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J. H. Francis, P. Myskowski, M.-H. Heinemann; Trichomegaly With Both Classes of Epidermal Growth Factor Inhibitors: Monoclonal Antibodies and Tyrosine Kinase Inhibitors. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5695.
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Trichomegaly effect, its onset, association to dermatological findings, and other observations in a small series of 8 cancer patients receiving either class of epidermal growth factor receptor inhibitors.
Retrospective observational case series of patients receiving either epidermal growth factor monoclonal antibody (cetuximab, panitumumab) or tyrosine kinase inhibitor (erlotinib) were followed clinically and documented through color photography.
Both patients receiving epidermal growth factor monoclonal antibody (cetuximab, panitumumab) and tyrosine kinase inhibitor (erlotinib) for malignancy demonstrate trichomegaly with abnormal, tortuous, overgrown eyelashes. All patients displayed dermatological changes of either acneiform rash or xerosis, followed by trichomegaly at an estimated onset of 26.5 weeks after initial treatment dose. One patient’s course was complicated by trichiasis, another by lid hyperemia and one patient developed trichomegaly two months post-treatment completion.
Increasing numbers of malignancies are being treated with several classes of epidermal growth factor inhibitors, including monoclonal antibodies and tyrosine kinase inhibitors; our patients demonstrate that both cause trichomegaly. In our series trichomegaly co-occured with dermatological changes, a possible indication of receptor saturation, with trichomegaly onset post rash. It is possible to develop delayed trichomegaly even two months post-treatment completion, despite rash onset during initial therapy. Given the anticipated expanded use of these drugs, it is important for ophthalmologists to be aware of the trichomegaly effect, its complications and variability in onset.
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