Multidirectional pattern of hair growth with carflizomib use for multiple myeloma

Introduction Extensive use of novel therapies for multiple myeloma has been accompanied by intriguing toxic side effects affecting various organs and organ systems. Although skin effects with some of these medications have been well-documented, hair changes are fairly rare. Case report We report herein a unique case of a patient with myeloma who developed multidirectional pattern of scalp hair growth starting at 14 months into treatment with cafilzomib. This pattern of hair growth had not previously been described in the literature. Management and outcome: The patient had a near-complete response to caflizomib, and continues on this maintenance treatment regimen to the present day. There has not been any change in the unusual hair appearance and texture. Discussion A score of 5 on the Naranjo nomogram makes the causality relationship between carfilzomib use and the multidirectional hair growth probable. The mechanism by which carfilzomib causes this hair change remains to be elucidated.