Paraneoplastic hypertrichosis lanuginosa acquisita

A man in his 70s consulted for the growth of fine long, white, fetus-like hair over his face that was noticed in the past one month [Figures 1-3]. A diagnosis of acquired hypertrichosis lanuginosa was made. Computerized tomography scan and biopsy confirmed an advanced lung adenocarcinoma. The patient denied chemotherapy treatment and was referred to the palliative care unit, and he died five months after diagnosis. The skin condition showed no changes during follow-up.

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Figure 1:

Acquired paraneoplastic hypertrichosis. The appearance of fine hair on the forehead and pinna

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Figure 2:

Acquired paraneoplastic hypertrichosis lanuginosa. White fine hair on the patient’s nose, a usually hairless site

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Figure 3:

Excessive growth of fine white lanugo over the pinna

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Acquired hypertrichosis lanuginosa is a rare paraneoplastic cutaneous syndrome, reported to be associated with colorectal or pulmonary adenocarcinomas and is considered a poor prognostic sign for patients with such carcinomas. The growth of lanugo hair seems to be triggered by an embryonic-like peptide produced by the tumor. A screening for occult malignant neoplasms must be performed in all cases.