Some patients with cancer may develop a proliferation of lanuga hair as a paraneoplastic syndrome. The precise cause is uncertain but may be related to release of cytokines by the tumor cells.
Features of lanugo hair:
(1) fine and thin
(2) nonpigmented
(3) may become very long
Location where lanugo hairs may proliferate:
(1) eyebrows and eyelashes
(2) forehead
(3) ears
(4) nose
(5) trunk and back
(6) axillae
(7) extremities
Tumors associated with paraneoplastic hypertrhichosis with lanugo hair growth:
(1) colon or rectum
(2) lung
(3) breast
(4) other (parotid carcinoma, extraskeletal Ewing's sarcoma, acute myeloid leukemia)
The hypertrichosis may precede diagnosis of the underlying tumor.
It may occur with other paraneoplastic skin conditions (acanthosis nigricans, papillary hypertrophy of the tongue, glossitis).
The growth of hair may regress with successful treatment of the tumor, or it may remain unchanged. If it does regress, then it may reappear with tumor recurrence.
Differential diagnosis:
(1) hirsutism
(2) acquired hypertrichosis lanuginosa due to other cause
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