Cicatricial ectropion associated with treatment of metastatic colorectal cancer with cetuximab

Cetuximab is a monoclonal antibody that binds to the epidermal growth factor receptor (EGFR) of cancer cells expressing EGFR and prevents dimerization and downstream cell signaling pathways. It has been shown to prolong survival in patients with metastatic colorectal cancer. Cutaneous toxicity is relatively common because of the inhibition of EGFR of normal epidermal cells. We present a 49-year-old man with metastatic colon cancer who had development of periocular skin toxicity, madarosis, and cicatricial ectropion after the addition of weekly cetuximab infusions to his baseline chemotherapy. His findings resolved within weeks of the discontinuation of the drug. Cicatricial ectropion is a potential sequela of EGFR inhibition by cetuximab and can resolve without surgical intervention with the discontinuation of this drug.