%0 Journal Article
%T Erlotinib Associated Trichomegaly in A Patient With Chronic Latanoprost Use - Erlotinib Associated Trichomegaly in A Patient With Chronic Latanoprost Use - Open Access Pub
%A Burris CK
%A Cowan CL Jr
%A Richards NQ
%J OAP | Home | Journal of Hematology and Oncology Research | Open Access Pub
%D 2018
%X Trichomegaly is a known adverse effect with the epidermal growth factor receptor inhibitor (EGFRI) and prostaglandin analogue drug classes. We present a chronic Latanoprost user who developed symptomatic trichomegaly subsequent to initiating an EGFRI medication and believe this case offers evidence that the two classes of medications may cause a similar eyelash manifestation through different mechanisms. DOI10.14302/issn.2372-6601.jhor-15-667 It has been predicted that the world cancer incidence will nearly double over the next 20 years.1 Though chemotherapies are constantly evolving, the use of EGFRI medications may also increase. Epidermal growth factor is thought to play a role in the conversion of hair follicles from the active anagen phase to the quiescent catagen phase, regulating eyelash length.2 Though most chemotherapeutic agents would be expected to cause hair loss, EGFRI drugs such as Erlotinib have been shown to cause a paradoxical trichomegaly (increased length, thickness, and pigmentation) of the eyelashes due to a dysregulation of this process.3, 4, 5 Interestingly, prostaglandin F2¦Á receptors have been shown to be expressed predominately during the anagen phase in the inner root sheath of the bulb and stem of eyelashes.6 An 81 year-old African American male presented complaining of ocular irritation, foreign body sensation, and obstruction of his visual field by his eyelashes for over 1 year. Past ocular history was significant for primary open angle glaucoma, cataracts, posterior vitreous detachments, and elongated eyelashes requiring regular trimming approximately every 2 months during the past year. Family history was positive for glaucoma in his father and two siblings. Medical history included metastatic bronchogenic adenocarcinoma, hyperlipidemia, lipoma, benign prostatic hypertrophy, and seasonal allergies. Ophthalmic medications were Latanoprost, Timolol, and artificial tears used in both eyes. Systemic medications consisted of Guaifenesin, Albuterol, Sodium Chloride nasal spray, Loratadine, Erlotinib, Simvastatin, and Simethicone. On exam he appeared well nourished and his spectacle corrected visual acuity was 6/9-2 OD and 6/6-2 OS. External exam showed trichomegaly and trichiasis with cilia measuring 18 and 17mm OD and OS (see Figure 1and Figure 2). Both corneas had inferior superficial punctate keratopathy but there were no abrasions or ulcers. Besides a choroidal nevus, the remainder of his exam was similar to his previous with 1-2+ nuclear sclerotic change in his lenses, cup to disc ratios of 0.85 and 0.7, and posterior
%U https://www.openaccesspub.org/jhor/article/189