The
n e w e ng l a n d j o u r na l
of
m e dic i n e
images in clinical medicine Lindsey R. Baden, M.D., Editor
Sunitinib-Associated Hair Depigmentation
A
37-year-old, red-haired patient presented with strips of red Christina Brzezniak, D.O. and white hair 4 months after starting treatment with sunitinib for thymic Walter Reed National Military Medical carcinoma as part of an experimental protocol. She had been taking 50 mg Center of sunitinib daily for 28 days, followed by a 14-day break (the dose approved by the Bethesda, MD Food and Drug Administration for the treatment of renal-cell carcinoma and gas- [email protected] trointestinal stromal tumors). Sunitinib is an oral small-molecule inhibitor of several receptor tyrosine kinases that affect tumor growth, angiogenesis, and metas- Eva Szabo, M.D. tasis, including c-KIT. Inhibition of c-KIT signaling reduces hair pigmentation by National Institutes of Health decreasing melanin synthesis. Changes in both hair and skin pigmentation are Bethesda, MD recognized effects of treatment with sunitinib. The patient’s changes in hair color mirror the pattern of sunitinib ingestion, with white and red bands corresponding to periods of drug ingestion and drug holiday, respectively. She was treated with six cycles of sunitinib, during which the changes in hair color persisted, until disease progression. The patient was doing well clinically and was awaiting her next line of treatment.
DOI: 10.1056/NEJMicm1309906 Copyright © 2014 Massachusetts Medical Society.
n engl j med 370;17 nejm.org april 24, 2014
The New England Journal of Medicine Downloaded from nejm.org at SHIRP on December 11, 2016. For personal use only. No other uses without permission. Copyright © 2014 Massachusetts Medical Society. All rights reserved.
e27
n e w e ng l a n d j o u r na l
of
m e dic i n e
images in clinical medicine Lindsey R. Baden, M.D., Editor
Sunitinib-Associated Hair Depigmentation
A
37-year-old, red-haired patient presented with strips of red Christina Brzezniak, D.O. and white hair 4 months after starting treatment with sunitinib for thymic Walter Reed National Military Medical carcinoma as part of an experimental protocol. She had been taking 50 mg Center of sunitinib daily for 28 days, followed by a 14-day break (the dose approved by the Bethesda, MD Food and Drug Administration for the treatment of renal-cell carcinoma and gas- [email protected] trointestinal stromal tumors). Sunitinib is an oral small-molecule inhibitor of several receptor tyrosine kinases that affect tumor growth, angiogenesis, and metas- Eva Szabo, M.D. tasis, including c-KIT. Inhibition of c-KIT signaling reduces hair pigmentation by National Institutes of Health decreasing melanin synthesis. Changes in both hair and skin pigmentation are Bethesda, MD recognized effects of treatment with sunitinib. The patient’s changes in hair color mirror the pattern of sunitinib ingestion, with white and red bands corresponding to periods of drug ingestion and drug holiday, respectively. She was treated with six cycles of sunitinib, during which the changes in hair color persisted, until disease progression. The patient was doing well clinically and was awaiting her next line of treatment.
DOI: 10.1056/NEJMicm1309906 Copyright © 2014 Massachusetts Medical Society.
n engl j med 370;17 nejm.org april 24, 2014
The New England Journal of Medicine Downloaded from nejm.org at SHIRP on December 11, 2016. For personal use only. No other uses without permission. Copyright © 2014 Massachusetts Medical Society. All rights reserved.
e27
