Hirsutism

From Wikipedia, the free encyclopedia - View original article

Hirsutism
Classification and external resources
Nuremberg chronicles - Strange People - Hairy Lady (XIIv).jpg
A woman with hirsutism, as depicted in the Nuremberg Chronicle (1493)
ICD-10L68.0
ICD-9704.1
DiseasesDB20309
MedlinePlus003148
eMedicinemed/1017 derm/472
MeSHD006628
 
Jump to: navigation, search
"Hirsute" redirects here. For the botanical term, see indumentum.
Hirsutism
Classification and external resources
Nuremberg chronicles - Strange People - Hairy Lady (XIIv).jpg
A woman with hirsutism, as depicted in the Nuremberg Chronicle (1493)
ICD-10L68.0
ICD-9704.1
DiseasesDB20309
MedlinePlus003148
eMedicinemed/1017 derm/472
MeSHD006628

Hirsutism is the excessive hairiness[1] on women[2] in those parts of the body where terminal hair does not normally occur or is minimal - for example, a beard or chest hair. It refers to a male pattern of body hair (androgenic hair) and it is therefore primarily of cosmetic and psychological concern. Hirsutism is a medical sign rather than a disease and may be a sign of a more serious medical condition, especially if it develops well after puberty. The amount and location of the hair is measured by a Ferriman-Gallwey score.

Signs and symptoms[edit]

Hirsutism-3.jpg

Hirsutism affects women and sometimes men, since the rising of androgens causes a male pattern of body hair, sometimes excessive, particularly in locations where women normally do not develop terminal hair during puberty (chest, abdomen, back and face). The medical term for excessive hair growth that affect both men and women is hypertrichosis.

Causes[edit]

Hirsutism can be caused by either an increased level of androgens, the male hormones, or an oversensitivity of hair follicles to androgens. Male hormones such as testosterone stimulate hair growth, increase size and intensify the growth and pigmentation of hair. Other symptoms associated with a high level of male hormones include acne, deepening of the voice, and increased muscle mass.

Growing evidence implicates high circulating levels of insulin in women for the development of hirsutism. This theory is speculated to be consistent with the observation that obese (and thus presumably insulin resistant hyperinsulinemic) women are at high risk of becoming hirsute. Further, treatments that lower insulin levels will lead to a reduction in hirsutism.

It is speculated that insulin, at high enough concentration, stimulates the ovarian theca cells to produce androgens. There may also be an effect of high levels of insulin to activate insulin-like growth factor 1 (IGF-1) receptor in those same cells. Again, the result is increased androgen production.

Signs that are suggestive of an androgen-secreting tumor in a patient with hirsutism is rapid onset, virilization and palpable abdominal mass.

The following may be some of the conditions that may increase a woman's normally low level of male hormones:

Diagnosis[edit]

One method of evaluating hirsutism is the Ferriman-Gallwey score which gives a score based on the amount and location of hair growth on a woman.[5]

Diagnosis of patients with even mild hirsutism should include assessment of ovulation and ovarian ultrasound (because of the high prevalence of polycystic ovary syndrome), as well as 17-hydroxyprogesterone (because of the possibility of finding nonclassic 21-hydroxylase deficiency[6]).

Other blood value that may be evaluated in the workup of hirsutism include:

If no underlying cause can be identified, the condition is considered idiopathic.

Treatment[edit]

Many women with unwanted hair seek methods of hair removal. However, the causes of the hair growth should be evaluated by a physician, who can conduct blood tests, pinpoint the specific origin of the abnormal hair growth, and advise on the treatment.

Pharmacological[edit]

Pharmacological treatments include:[4]

Other methods[edit]

See also[edit]

References[edit]

  1. ^ "Hirsutism" at Dorland's Medical Dictionary
  2. ^ "Merck Manuals online medical Library". Merck & Co. Retrieved 2011-03-04. 
  3. ^ Somani N, Harrison S, Bergfeld WF (2008). "The clinical evaluation of hirsutism". Dermatol Ther 21 (5): 376–91. doi:10.1111/j.1529-8019.2008.00219.x. PMID 18844715. 
  4. ^ a b c d Unluhizarci K, Kaltsas G, Kelestimur F (2012). "Non polycystic ovary syndrome-related endocrine disorders associated with hirsutism". Eur J Clin Invest 42 (1): 86–94. doi:10.1111/j.1365-2362.2011.02550.x. PMID 21623779. 
  5. ^ Ferriman D, Gallwey JD (November 1961). "Clinical assessment of body hair growth in women". J. Clin. Endocrinol. Metab. 21 (11): 1440–7. doi:10.1210/jcem-21-11-1440. PMID 13892577. 
  6. ^ Di Fede, G.; Mansueto, P.; Pepe, I.; Rini, G. B.; Carmina, E. (2010). "High prevalence of polycystic ovary syndrome in women with mild hirsutism and no other significant clinical symptoms". Fertility and Sterility 94 (1): 194–197. doi:10.1016/j.fertnstert.2009.02.056. PMID 19338993.  edit
  7. ^ Karakurt F, Sahin I, Güler S et al. (April 2008). "Comparison of the clinical efficacy of flutamide and spironolactone plus ethinyloestradiol/cyproterone acetate in the treatment of hirsutism: a randomised controlled study". Adv Ther 25 (4): 321–8. doi:10.1007/s12325-008-0039-5. ISBN [[Special:BookSources/1232500800395|1232500800395[[Category:Articles with invalid ISBNs]]]] Check |isbn= value (help). PMID 18389188. 
  8. ^ Taylor SI, Dons RF, Hernandez E, Roth J, Gorden P. (December 1982). Insulin resistance associated with androgen excess in women with autoantibodies to the insulin receptor 97 (6). pp. 851–5. PMID 7149493. 

External links[edit]