Trichoscopy and LC-OCT findings in sonidegib-induced alopecia in patients with advanced basal cell carcinoma
https://doi.org/10.4081/dr.2024.10113
Accepted: 25 August 2024
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Sonidegib is a Hedgehog pathway inhibitor (HHIs) used as first-line systemic treatment for patients with advanced basal cell carcinoma (aBCC). Alopecia is reported as a frequent adverse event (AE), occurring in 49% of patients. Forty-five patients with aBCC were treated with sonidegib between December 2022 and December 2023; among them, 11/45 patients developed alopecia. Trichoscopic features included yellow dots, black dots, exclamation mark hairs, and broken hairs. Upon LC-OCT examination, yellow dots were seen as dilated follicular dark spaces containing malted nonhomogeneous material and outlined by bright collarets; black dots corresponded to normal-sized follicular ostia filled with bright, homogeneous material and cadaverized hair; exclamation mark hairs were short dark dysmorphic hairs with a different size of proximal and distal end and broken hairs were short dysmorphic hairs. LC-OCT may provide additional insights of early signs and clinical evolution of sonidegib-induced alopecia in patients with aBCC.
Peris K, Fargnoli MC, Kaufmann R, et al. European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma-update 2023. Eur J Cancer 2023;192:113254. DOI: https://doi.org/10.1016/j.ejca.2023.113254
Brancaccio G, Pea F, Moscarella E, Argenziano G. Sonidegib for the Treatment of Advanced Basal Cell Carcinoma. Front Oncol 2020;10:582866. DOI: https://doi.org/10.3389/fonc.2020.582866
Cantelli M, Cappello M, Vastarella M, et al. Vismodegib-induced alopecia: trichoscopic and confocal microscopy evaluation. Skin Appendage Disord 2020;6:384-8. DOI: https://doi.org/10.1159/000510121
Lacouture ME, Dréno B, Ascierto PA, et al. Characterization and management of hedgehog pathway inhibitor-related adverse events in patients with advanced basal cell carcinoma. Oncologist 2016;21:1218-29. DOI: https://doi.org/10.1634/theoncologist.2016-0186
Ferguson JS, Hannam S, Toholka R, et al. Hair loss and Hedgehog inhibitors: a class effect? Br J Dermatol 2015;173:262-4. DOI: https://doi.org/10.1111/bjd.13619
Migden M, Farberg AS, Dummer R, et al. A review of hedgehog inhibitors sonidegib and vismodegib for treatment of advanced basal cell carcinoma. J Drugs Dermatol 2021;20:156-65. DOI: https://doi.org/10.36849/JDD.5657
Annunziata MC, Tosti A, Fattore D, et al. Trichoscopic patterns and confocal microscopy features of chemotherapy-induced alopecia. Skin Appendage Disord 2023;9:346-50. DOI: https://doi.org/10.1159/000531183
Ogien J, Tavernier C, Fischman S, Dubois A. Line-field confocal optical coherence tomography (LC-OCT): principles and practical use. Ital J Dermatol Venerol 2023;158:171-9. DOI: https://doi.org/10.23736/S2784-8671.23.07613-2
Monnier J, Tognetti L, Miyamoto M et al. In vivo characterization of healthy human skin with a novel, non-invasive imaging technique: line-field confocal optical coherence tomography. J Eur Acad Dermatol Venereol 2020;34:2914-21. DOI: https://doi.org/10.1111/jdv.16857
Suppa M, Palmisano G, Tognetti L et al. Line-field confocal optical coherence tomography in melanocytic and non-melanocytic skin tumors. Ital J Dermatol Venerol 2023;158:180-9. DOI: https://doi.org/10.23736/S2784-8671.23.07639-9
Donelli C, Rubegni P, Tognetti L, et al. Inflammatory and infectious skin diseases in line-field confocal optical coherence tomography: state of the art. Ital J Dermatol Venerol 2023;158:190-6. DOI: https://doi.org/10.23736/S2784-8671.23.07607-7
Verzì AE, Lacarrubba F, Dall'Oglio F, et al. Subclinical, early hair regrowth in alopecia areata patients under treatment with baricitinib detected by line-field confocal optical coherence tomography evaluation. J Eur Acad Dermatol Venereol 2024;38:e459-61. DOI: https://doi.org/10.1111/jdv.19623
Lacarrubba F, Verzì AE, Dall'Oglio F, et al. Alopecia areata: Line-field confocal optical coherence tomography features and dermoscopy correlation. Skin Res Technol 2024;30:e13596. DOI: https://doi.org/10.1111/srt.13596
Chen AP, Setser A, Anadkat MJ, et al. Grading dermatologic adverse events of cancer treatments: the Common Terminology Criteria for Adverse Events Version 4.0. J Am Acad Dermatol 2012;67:1025-39. DOI: https://doi.org/10.1016/j.jaad.2012.02.010
Dessinioti C, Antoniou C, Stratigos AJ. From basal cell carcinoma morphogenesis to the alopecia induced by hedgehog inhibitors: connecting the dots. Br J Dermatol 2017;177:1485-94. DOI: https://doi.org/10.1111/bjd.15738
Dummer R, Guminksi A, Gutzmer R, et al. Long-term efficacy and safety of sonidegib in patients with advanced basal cell carcinoma: 42-month analysis of the phase II randomized, double-blind BOLT study. Br J Dermatol 2020;182:1369-78. DOI: https://doi.org/10.1111/bjd.18552
Dummer R, Ascierto PA, Basset-Seguin N, et al. Sonidegib and vismodegib in the treatment of patients with locally advanced basal cell carcinoma: a joint expert opinion. J Eur Acad Dermatol Venereol 2020;34:1944-56. DOI: https://doi.org/10.1111/jdv.16230
Wikramanayake TC, Haberland NI, Akhundlu A, et al. Prevention and treatment of chemotherapy-induced alopecia: what is available and what is coming? Curr Oncol 2023;30:3609-26. DOI: https://doi.org/10.3390/curroncol30040275
Waśkiel A, Rakowska A, Sikora M, et al. Trichoscopy of alopecia areata: An update. J Dermatol 2018;45:692-700. DOI: https://doi.org/10.1111/1346-8138.14283
Franceschini C, Garelli V, Persechino F, et al. Dermoscopy and confocal microscopy for different chemotherapy-induced alopecia (CIA) phases characterization: Preliminary study. Skin Res Technol 2020;26:269-76. DOI: https://doi.org/10.1111/srt.12790
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
