Hypertrichosis or Wolf Man Syndrome is the presence of hair (lanugo, hairy or terminal) excessive and abnormal in places of the body or face that do not usually present it. The Lanugo is fine and thin hair that already appears in the fetus and disappears at the end of pregnancy or during the baby’s first months of life. The hair or hairy hairs are short and produce the hair follicles that penetrate papillary dermis. Finally, the terminal hairs are formed by the hair follicles that penetrate to the reticular dermis; They are large, they have color and marrow.
Hypertrichosis is a rare disease and an aesthetic problem that is usually hereditary although it does not imply a health risk. It can also appear due to acquired causes or be a cutaneous manifestation of a systemic disease. It can be located but in its most extreme forms it is widespread except in the palms of the hands and soles of the feet.
Causes of hypertrichosis
Changes in the hair growth cycle
The causes of hypertrichosis are very varied and pathophysiology is an enigma. The main mechanisms of hypertrichosis are three: the conversion of hair in terminal hair, changes in the cycle of hair growth or increase in the density of the hair follicles.
The classification of hypertrichosis is:
– Congenital hypertrichosis (located and generalized). Localized congenital hypertrichosis are: congenital nevus, smooth muscle Hamartoma, Nevoid hypertrichosis, neurofibromas, ulnar hypertrichosis (hairy elbows), hemihypertrophy, hair malformations hair hair in palms and plants, hypertrichosis of the atrial pavilion, spinal spinal and hypertricosis hypertricis.
– Generalized congenital hypertrichosis are divided into syndromes with hypertrichosis as a primary manifestation or as secondary manifestation.
– Generalized hypertrichosis as primary manifestation: congenital lanuginous hypertrichosis (HLC), amusement syndrome, generalized congenital hypertrichosis or linked to X, gingival fibromatosis and osteochondrodisplasia,
-Generalized hypertrichosis as secondary manifestation: Brachman-Lande syndrome, teratogenic syndromes, lipoatrophy (such as lipoatrophic diabetes), mucopolisacaridosis, Winchester syndrome, porfirias, blond-taybi syndrome, Coffin-Siris syndrome, hemimaxillofacial dysplasia, craniofacial dysostosis, ITO HYPOMELANIS AND MELAS SYNDROME.
– acquired hypertrichosis (located and generalized). The localized acquired hypertrichosis are: Becker Nevo, hypertrichosis associated with local inflammation, hypertrichosis of the atrial pavilion and trichomegaly.
– The generalized acquired hypertrichosis are: by brain alterations such as postviral encephalitis, chronic exposure to mercose (acroodynia), infections such as tuberculosis that can cause transitory hypertricosis in children, malnutrition, dermatomyositis, hyperthyroidism or hypothyroidism, Lawrence-Seip syndrome Acquired, acquired lanuginous hypertrichosis that is associated with lung and colon neoplasms, poems syndrome, and pharmacological hypertrichosis such as that produced by Latanoprost in the treatment against glaucoma.
Symptoms of hypertrichosis
Increased body hair
The sign of the appearance of hypertrichosis is hair growth in areas where it is not usual. We point below the symptoms or types of growth depending on the type of hypertrichosis.
– In the congenital nevus your hair grows inside the injury.
– Smooth muscle hamartoma is a hyperpigmented plaque or tumor in “cobbled”; It predominates in trunk with hypertrichosis.
– Nevoid hypertrichosis is the increase in the number of normal hair follicles in a congenital plate of terminal hair.
– Hypertrichosis associated with soft tumors in the skin or under it (neurofibromas) supposes hypertrichosis and hyperpygmentation in neurofibroma.
– Ulnar hypertrichosis (hairy elbows) is excessive bilateral hair growth. It usually appears in childhood, develops during childhood, and is resolved partially or completely during adolescence.
– Hemihypertrophy is the growth of terminal hair in the middle of the body or just a part. There may be abnormal nail growth, increased hair diameter and the number of terminal hair follicles where there are usually hairy follicles.
– The pylous cutaneous malformation of palms and plants. It has a dominant autosomal inheritance pattern. It is very rare.
– Spinal hypertrichosis has excess hair in the spinal region or “faun tail”, or as hair hair on the midline.
– Previous cervical hypertrichosis is a small area of terminal hair located on Adam’s nut.
– Lanuginous congenital hypertrichosis (HLC) is a lanugo that remains throughout the body except palms, plants and mucous membranes after birth.
– Ambras syndrome is abundant hairy hair, ears and shoulders whose density does not decrease with age. There may be facial and dental dysmorphia.
– Congenital hypertrichosis generalized or linked to the X. Only one family has been reported in Mexico with a recessive inheritance pattern linked to X, so men have greater condition than women. The affected gene is the X24-Q27.1. There are congenital terminal hypertrichosis in face, trunk and limbs, respecting palms, plants and mucous membranes.
– Osteochondrodisplasia associated with hypertrichosis is a recessive autosomal syndrome that can present a large fetus (macrosomia) and dilated heart (cardiomegaly) in children.
– Brachman-Lande’s syndrome. It is characterized by thick and convergent eyebrows, eyelash hypertrichosis, low hair implementation and low hairy hair cover. Other characteristics are: mental retardation, depressed nasal bridge, low implementation of atrial pavilions, abnormalities of the development of arms and feet, or small and irregular teeth.
– Teratogenic syndromes that include: hypertrichosis, nail hypoplasia, lip and cleft palate, medium facial hypoplasia, upper lip hyperplasia and low birth weight.
– Lipoatropia includes acanthosis nigricans, excessive sweating (hyperhidrosis), prominent veins (phlebomegaly), fat accumulations that harden (xantomas) and hypertrichosis of face, neck and limbs.
– Muccopolysacaridosis that are characterized by low size, skeletal abnormalities, liver and spleen recreation (hepatoesplenomegaly) and cardiac abnormalities.
– Tye skin syndrome or “like stone” skin. Excess hair growth is mild and is presented in half cases.
– Winchester syndrome is distinguished by thick skin with hypertrichosis, low size, destruction of severe bone tissue in the bones of Carpo and Tarsus, and corneal opacity.
– Porphyrias that present skin photosensitivity with ampoules, scars, and hypertrichosis in areas exposed to the sun.
– Rubinstein-Taybi syndrome characterized by “little bird” face, bulky and pink scars (keloids), large fingers in hands and feet, short size and mental retardation.
– Schinzel-Giedion syndrome presents hypertrichosis in face and limbs, is accompanied by depressed nasal bridge, wide front, facial hypoplasia, dental and skeletal alterations.
– Barber-Say syndrome is characterized by atrophic skin with hypertrichosis in front, neck, trunk and limbs, facial fissure (macrostomy), mental retardation and excessive tear (ectropion).
– Coffin-Siris syndrome is presented with lumbosacral and eyebrow hypertrichosis, absence of fingers in hands and feet, mental retardation and growth, scarce hair on the scalp, laxity of joints, microcephaly, prominent lips and depressed nasal bridge.
– In hemimaxillofacial dysplasia there is facial asymmetry, upper part of the enlarged jaw on the one hand and occasionally facial hypertrichosis on one side.
– Craneofacial dysostosis has terminal hair hypertrichosis predominates in trunk and limbs with major lip hypoplasia, and dental and eye abnormalities.
– Itosis of Ito is characterized by hypopigmented spots that follow the Blaschko lines (skin lines that are not seen in normal conditions). There may be neurological manifestations.
– Melas syndrome raises dermatological manifestations that include a pruriginous erythema in the neck and terminal hair hypertrichosis on the feet.
– Becker’s Nevo is a tumor (Hamartoma) irregular pigmented with increased hair growth inside that predominates in trunk during puberty. It is generally acquired is more frequent in men and is presented in a solitary and unilateral way.
– Hypertrichosis associated with local inflammation appears due to the use of chemicals such as iodine. Excessive hair is temporary and disappears after a few months.
– Hypertrichosis of the atrial pavilion predominates in elderly men, patients with HIV, children of diabetic mothers and diabetic patients.
– Tricomegaly is the isolated alteration of the eyelashes.
– Acrodynia is characterized by erythema in fingers of hands, feet and nose, perspiration and excessive salivation, and pain in feet and hands. There are cases with the presence of hypertrichosis.
– Tuberculosis can cause transient hypertrichosis in children, with predominance of hair in face and limbs.
– Youth dermatomyositis has face and limb hypertrichosis.
– In cases of hypothyroidism hypertrichosis is common in children and disappears with substitute therapy. In patients with hyperthyroidism, hypertrichosis has been reported in mixedma cases, a type of edema, pretibial due to accumulation of long sugar molecules (mucopolysaccharides).
– Lawrence-Seip syndrome, which can appear after a viral infection, raises loss of subcutaneous fat, hyperinsulinemic diabetes, acanthosis nigricans and hypertrichosis.
– Hypertrichosis can be presented in acquired porphyrias such as cutaneous porphyria it takes to be caused by exposure to substances such as hexaclorobenzeno, a pesticide.
– In acquired lanuginous hypertrichosis there is regression of normal hair follicles to lanugo hair that predominates in the face.
– In poems syndrome, cutaneous changes include hyperpigmentation, generalized hypertrichosis although predominant in the lower extremities, thickening of the skin, edema and flat spots with relief (skin angiomas).
– Pharmacological hypertrichosis appears when following a pharmacological treatment and predominates in trunk and limbs; Rarely the face.
Diagnosis of hypertrichosis
Image analysis and tests
In addition to physical examination and symptom description, the specialist will request blood analysis to know hormonal levels and image tests such as ultrasound and/or computerized tomographs to detect tumors or other disorders that may cause abnormal hair growth.
Treatment and medication of hypertrichosis
Eliminate the trigger, discoloration and shaped methods
If hypertrichosis appears due to a trigger the objective, the objective is to treat the disease or cause. When it is primary, the options are reduced to hair makeup, discoloration, and depilatory methods between which the hair removal technique or definitive hair removal that manages to destroy the germ hair cells of the hair stands out.
Hypertrichosis prevention
There is no
No prevention measures have been described against hypertrichosis.
This article was published at La Vanguardia on November 7, 2020
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