Androgen dependence of hirsutism, acne, and alopecia in women: retrospective analysis of 228 patients investigated for hyperandrogenism.

摘要: Hirsutism, acne, alopecia, and oligo-amenorrhea are clinical expressions of hyperandrogenism, one the most frequent endocrine disorders in women reproductive age. Women referred to our clinics for skin symptoms hyperandrogenism underwent a laboratory workup evaluate hormone measurements received antiandrogen therapy. We retrospectively analyzed outcome 228 consecutive patients investigated over 6 years.Patients with hirsutism had higher levels androstenedione, dehydroepiandrosterone sulfate (DHEAS), salivary testosterone; lower sex hormone-binding globulin (SHBG); prevalence than while acne showed intermediate values. Hirsutism score correlated positively DHEAS, testosterone, negatively SHBG; testosterone highest correlation coefficient. Total was not significantly different among hirsutism, or did correlate score. were sensitive no androgenic parameter alone allowed us identify all cases hyperandrogenism.Patients central European origin sought consultation milder scores southern origin. There was, however, difference clinical-biological between these groups, arguing against differences sensitivity androgens.Polycystic ovary syndrome, defined as (hirsutism elevated androgens) oligo-amenorrhea, diagnosed 63 (27.6%), an underestimate compared other reports that include systematic ovarian ultrasound studies. Neither pelvic ultrasound, used limited number cases, nor luteinizing hormone/follicle-stimulating ratio helped distinguish polycystic syndrome from diagnostic groups. These included eumenorrhea (101 patients; 44.3%); normal androgens (acne alopecia eumenorrhea) (51 22.4%); isolated low SHBG (7 3.1%); nonclassical congenital adrenal hyperplasia (4 1.8% total, 4.9% undergoing cosyntropin stimulation tests); tumor (2 0.9%).Ethinylestradiol high-dose cyproterone acetate treatment lowered 53.5% baseline at 1 year, also effective treating alopecia. The benefit is ascribed peripheral antiandrogenic effect well hormone-suppressive this combination. Salivary marked proportional decrease under treatment. Cost-effectiveness tolerance ethinylestradiol drug therapies hirsutism. less potent therapy spironolactone only, without effect, androgens.