Werewolf syndrome also known as Ambras syndrome and hypertrichosis is an abnormal amount of hair growth on the body, it is called werewolf syndrome because the patient in this condition looks like a werewolf. There are generally two types of hypertrichosis, generalized hypertrichosis that occurs over the entire body and localized hypertrichosis that is restricted to a particular place. Werewolf disease can be congenital (present at birth) or may be acquired later in life.
1. Congenital – This type of hypertrichosis is present at birth and less common than acquired form of the disease-
a. Hypertrichosis lanuginosa – We can notice this at birth. In this infant completely covers in thin lanugo hair. Normally lanugo hairs are generally shed after birth and replaced by a vellus hair but in this condition lanugo hair not shed and remains on the body. The palms of hands, the sole of feet and the mucous membrane are not affected by this condition.
b. Generalized hypertrichosis – generalized hypertrichosis it is a situation in which there is excessive hair on the face and upper body surface in the males but this is not in the case of females. Mucous membrane, palms, and feet do not affect in this condition.
c. Terminal hypertrichosis – terminal hypertrichosis is a condition in which there are fully pigmented terminal hairs on all over the body. This condition is generally accompanied by gingival hyperplasia. It is a most suitable form for werewolf syndrome because of the presence of thick, dark hair on the body.
d. Circumscribed hypertrichosis – circumscribed hypertrichosis is a condition in which there is generalized present of vellus hair on the upper extremities. It is generally restricted to certain parts of the body. There is a syndrome called hairy elbow syndrome in which there is the excessive growth of hair around the elbow, it is a type of circumscribed hypertrichosis.
e. Localized hypertrichosis – localized hypertrichosis is a condition in which there is a localized increase in hair density and length.
f. Nevoid hypertrichosis – nevoid hypertrichosis is a condition in which there is may be present at birth or may be acquired during the life.
a. Hypertrichosis lanuginosa – hypertrichosis lanuginose is the rapid growth of lanugo hair, particularly on the face. Hair also grows on trunk and armpits while the palms and soles are unaffected. The hair is very thin and unpigmented.
b. Generalized hypertrichosis – Generalized hypertrichosis is generally affected the chin, cheeks and upper lip; they also affect the forearm and legs but are less common. In this, there is also abnormal hair growth on eyelashes condition known as trichiasis. Some drugs can also cause this condition like minoxidil used for hypertension can also cause this disease.
c. Patterned hypertrichosis – Patterned hypertrichosis is an increase in hair growth in pattern form.
d. Localized hypertrichosis – Localized hypertrichosis is increased in hair density and length and restricted to certain areas of the body.
Sign and symptoms:-
The main feature of this disease is present of hairs all over the body. Hairs in hypertrichosis are usually longer than normals and are of many types like lanugo, vellus, and terminal. Circumscribed and localized forms generally lead to the growth of hair to a certain area.
It is generally diagnosed by looking at the body surface for the abnormal growth of hair according to age, sex, and ethnicity.