Newly recognized ocular side effects of erlotinib.

An 85-year-old man had a bilateral periorbital rash and conjunctivitis leading to lower eyelid ectropion and epiphora within 6 weeks of treatment with erlotinib (Tarceva, Genentech, Inc., San Francisco, CA, and OSI Pharmaceuticals, Melville, NY), a second-line antineoplastic agent. The treatment was discontinued secondary to toxicity, and the periorbital rash completely resolved within 6 weeks of cessation of the drug. To our knowledge, the periorbital rash resulting in bilateral lower eyelid ectropion associated with epiphora is a newly recognized side effect of erlotinib that is completely reversible with discontinuation of the drug. The rash and ectropion should be treated palliatively, and surgical intervention should be avoided unless the patient cannot be removed from treatment.