Loose Anchoring of Anagen Hairs and Pili Torti Due to Erlotinib

This case report described two female patients undergoing erlotinib treatment for cancer who experienced loose anagen hairs and pili torti, leading to nonscarring alopecia. The first patient, a 78-year-old with bronchioloalveolar carcinoma, and the second, a 60-year-old with metastatic adenocarcinoma of the lung, both showed changes in hair texture and volume. Trichoscopic and histopathologic examinations revealed irregular hair shaft shapes, broken hairs, and absence of sebaceous glands. The study suggested that erlotinib-induced hair changes might be due to abnormalities in the inner root sheath, similar to loose anagen hair syndrome. Topical steroids and minoxidil 5% improved the condition in the second patient after 3 months.