Hair loss with scarring and inflammation caused by Erlotinib resembling folliculitis decalvans

A 54-year-old female patient developed inflammatory alopecia after 8 months on erlotinib for pulmonary adenocarcinoma.

• Inflammatory alopecia occurred alongside diffuse erythema and painful keratotic plaques on the scalp.
• A skin biopsy revealed acute suppurative and destructive folliculitis, supporting a diagnosis of folliculitis decalvans.
• Discontinuation of erlotinib and introduction of antibiotics and corticosteroids led to marked improvement.
• Recurrence of lesions was noted upon reintroduction of erlotinib, even with a reduced dosage.
• Long-term use of systemic antibiotics is necessary to manage this condition and prevent recurrence.

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