Vismodegib-Induced Alopecia: Trichoscopic and Confocal Microscopy Evaluation

Area of Science:

• Dermatology
• Oncology
• Pharmacology

Background:

• Vismodegib is a first-in-class sonic hedgehog pathway inhibitor for advanced basal cell carcinoma (BCC).
• Alopecia is a frequent, reversible adverse event associated with vismodegib treatment, affecting up to 58% of patients.
• Understanding vismodegib-induced alopecia is crucial for patient management and treatment adherence.

Observation:

• This report presents two cases of locally advanced BCC patients experiencing alopecia during vismodegib therapy.
• Clinical, dermoscopic, and reflectance confocal microscopy (RCM) features of vismodegib-induced alopecia were documented.
• The study highlights the utility of trichoscopy and RCM in characterizing hair changes.

Findings:

• Alopecia is a significant adverse event that can lead to treatment discontinuation.
• The study provides the first documented RCM and dermoscopy findings in vismodegib-induced alopecia.
• Detailed microscopic evaluation aids in understanding the mechanism and progression of hair loss.

Implications:

• Alopecia management is essential for maintaining patient quality of life during vismodegib therapy.
• Trichoscopy and confocal microscopy are valuable tools for monitoring hair loss and treatment efficacy.
• Further research into mitigating vismodegib-induced alopecia may improve patient outcomes in advanced BCC treatment.