The n e w e ng l a n d j o u r na l
Images in Clinical Medicine
Tom Kovitwanichkanont,
M.B., B.S., M.P.H.
Mark Darling, M.B., Ch.B.
Peter MacCallum Cancer Centre
Melbourne, VIC, Australia
tom.kovitwanichkanont@gmail.com
This article was published on December
23, 2020, at NEJM.org.
e144
Downloaded from nejm.org by DANIELA SERBAN on December 30, 2020. For personal use only. No other uses without permission.
Copyright © 2020 Massachusetts Medical Society. All rights reserved.
of m e dic i n e
Chana A. Sacks, M.D., Editor
Acquired Hypertrichosis Lanuginosa
A
51-year-old woman presented to the dermatology clinic with a
2-month history of rapidly progressing hair growth on her face, neck, and
upper body in association with fatigue, weight loss, and cough. She had a
37-pack-year history of smoking but had no other relevant medical history and was
taking no medications. On examination, lanugo-type hair was observed on the face,
ears, neck, and upper trunk. This finding, referred to as acquired hypertrichosis
lanuginosa, may be associated with underlying cancer, endocrine disorders,
anorexia nervosa, or certain medications. Positron-emission tomography–computed
tomography revealed avid nodal disease in the right supraclavicular fossa and a
12-mm opacity in the lower lobe of the right lung. Biopsy of the right supra-
clavicular lymph node was performed, and a diagnosis of primary lung adenocar-
cinoma was made. The patient received treatment with chemotherapy and radiation
followed by durvalumab. Two months after the start of treatment, the hair growth
had slowed substantially, and the cough and weight loss had completely resolved.
DOI: 10.1056/NEJMicm2018796
Copyright © 2020 Massachusetts Medical Society.
n engl j med 383;27 nejm.org December 31, 2020
The New England Journal of Medicine