Inamadar Soumya S, Kumar N S Praveen
Department of Endocrinology, Care Hospitals, Hyderabad, Telangana, India.
Int J Trichology. 2022 Mar-Apr;14(2):71-72. doi: 10.4103/ijt.ijt_86_21. Epub 2022 Apr 4.
A sixty years postmenopausal lady presented with growing longer eyelashes for 8 years. She had thick, dark, curly eyelashes measuring 23 mm and 15 mm at the centre and periphery respectively suggesting marked trichomegaly. Increased vellus hair was noticed above lips and chin suggesting hypertrichosis. An important clue in history was the use of chemotherapeutic agent Erlotinib after bronchoscopic surgery for non-small cell lung carcinoma for the past 8 years. Erlotinib competitively binds to the tyrosine kinase domain of Epidermal Growth Factor Receptor inhibiting receptor activation and blocking the signal transduction. Thus, disrupting the transition of hair growth from anagen to telogen phase, leading to aberrant anagen phase and consequently abnormal hair growth. Trichomegaly is seen after 2-5 months of treatment. Mostly innocuous, it can lead to eyelid infections and rarely corneal ulceration. EGFR inhibitors are associated with hypertrichosis in other areas, as was the case in this patient. This case highlights the significance of detailed history including drugs, thus abating additional work-up for trichomegaly.
一位60岁的绝经后女性出现睫毛变长8年。她的睫毛浓密、黝黑且卷曲，中央和周边分别为23毫米和15毫米，提示明显的睫毛粗长症。上唇和下巴上方可见毳毛增多，提示多毛症。病史中的一个重要线索是，在过去8年里，她在非小细胞肺癌支气管镜手术后使用了化疗药物厄洛替尼。厄洛替尼竞争性结合表皮生长因子受体的酪氨酸激酶结构域，抑制受体激活并阻断信号转导。因此，扰乱了毛发从生长期到休止期的转变，导致异常的生长期，进而导致毛发异常生长。治疗2至5个月后可见睫毛粗长症。它大多无害，但可导致眼睑感染，很少导致角膜溃疡。表皮生长因子受体抑制剂与其他部位的多毛症有关，该患者就是如此。本病例突出了详细病史（包括用药情况）的重要性，从而避免了对睫毛粗长症进行额外的检查。
