Hirsutism | Figure 3.53 A: Traction alopecia (Courtesy of Dr. Paul Getz) B: Hirsutism in female, cheek (Reprint from Freedberg I, Sanchez M, eds. Current Dermatologic Diagnosis and Treatment. New York: Lippincott Williams & Wilkins; 2001) C: Clitoral hypertrophy in child with virilizing tumor (Reprint from Ibeiro RC, et al. Encyclopedia of Cancer. New York, NY: Springer; 2008) |
(Figure 3.53B) - Increased number of terminal hairs in women with a male pattern of distribution (unlike hypertrichosis which is an increase in the amount of hair growth anywhere on the body)
- Androgen-dependent areas include groin, lower abdomen, breasts, chin, lateral cheeks and upper cutaneous lip
- Causes:
- Adrenal: congenital adrenal hyperplasia, neoplasm
- Pituitary: Cushing’s disease, acromegaly, prolactin-secreting adenomas
- Ovary: ovarian tumor, PCOS
- Other signs of virilization: deepening of voice, temporal balding, amenorrhea, acne, clitoral hypertrophy (Figure 3.53C)
- Labs: free/total testosterone, LH, FSH, DHEA-S, ± fasting glucose (if concern for PCOS)
- Treatment: spironolactone, OCP, topical eflornithine, electrolysis, laser hair removal
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