Fatima Zahraa Sassine, Chourouq Mustapha Eid, Siham Alaoui, Karima Senouci, Mariame Meziane, Nadia Ismaili, Benzekri Laila
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 6
Date of Publication: 2026/06/14
Acquired hypertrichosis lanuginosa is a rare cutaneous disorder most commonly recognized as a paraneoplastic phenomenon. Non-malignant associations have been documented, with a severe catabolic state proposed as the common pathophysiologic denominator. We report the first case of diffuse acquired hypertrichosis occurring in the context of dermatomyositis complicated by pulmonary tuberculosis, in the absence of malignancy. A 44-year-old woman with newly diagnosed anti-NXP2-positive dermatomyositis developed diffuse hypertrichosis during a severe catabolic state, with a 22% loss of initial body weight and declining serum protein levels, driven by the convergence of active myositis and pulmonary tuberculosis unmasked by immunosuppressive therapy. The diagnosis of tuberculosis proved particularly challenging, as initial chest CT, three consecutive sputum cultures, sputum PCR, and PCR on cold abscess aspirates were all negative for Mycobacterium tuberculosis. Diagnosis was ultimately established through bronchoscopy with bronchoalveolar lavage PCR. A comprehensive paraneoplastic workup including whole-body ¹⁸F-FDG PET/CT excluded an underlying malignancy. The hypertrichosis resolved spontaneously upon initiation of anti-tuberculous therapy and nutritional recovery. This observation expands the spectrum of non-malignant conditions associated with acquired hypertrichosis lanuginosa and highlights the diagnostic challenges of tuberculosis reactivation in immunosuppressed patients with inflammatory myopathies.
acquired hypertrichosis lanuginosa, anti-nxp2, catabolic state, dermatomyositis, paraneoplastic workup, tuberculosis, dermatology
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