A 16-year-old Indian girl presented with increased facial hair growth, weight gain, amenorrhea and generalized weakness for the last 3 months. On examination she was found to have severe hirsutism, her modified Ferriman-Gallwey score was 24/36, she had broad purple striae on abdomen, hypertension and proximal myopathy. On investigations, the patient was found to have ACTH dependent Cushing's syndrome
Cushing Syndrome ; Hirsutism

D.R. presented with hirsutism, virilization and polycythemia. Hormonal assays, imaging studies and laparotomy revealed a steroid cell tumor of the ovary. The coexistence of ovarian tumor and polycythemia is discussed.
Human ; Female ; Adult ; POLYCYTHEMIA ; HIRSUTISM ; OVARY

Virilizing tumors during pregnancy are extremely rare. This case of a 33 year old, gravid 3 para 2, presented with hirsutism and clitoromegaly at 5 months age of gestation. Her past medical and menstrual histories were non-contributory. Ultrasound done during her prenatal check-up at 34 weeks age of gestation revealed an ovarian new growth on the left ovary features suggestive of a benign nature. On her 38th week of pregnancy, LTCS III with right tubal ligation and left salpingooophorectomy were performed and a baby boy weighing 3000 grams without any gross abnormalities was delivered. Histopathologically, the tumor proved to be a benign mucinous cystadenoma. This paper presented an ovarian mucinous cystadenoma with virilizing features that are transient and reversible. Therefore, an ovarian neoplasm should always be considered as a differential diagnosis for causes of virilization during pregnancy.
Human ; Female ; Adult ; HIRSUTISM ; PREGNANCY ; CYSTADENOMA, MUCINOUS

BACKGROUND

Polycystic ovarian syndrome (PCOS) is a common gynecologic endocrine disorder affecting between 2.2% and 26% of the population. It is typically characterized by hirsutism and signs of ovulatory dysfunction. Hirsutism is defined as the presence of excess body or facial terminal hair growth in females, following a male-like pattern. It is diagnosed using visual assessment methods, such as the modified Ferriman–Gallwey (mFG) scoring system, and biochemical tests, including measurements of total testosterone (tT) and the free androgen index (FAI).

The general objective of the study is to identify the correlation of visual scoring with the biochemical evaluation of hirsutism. Specific objectives include (1) to describe the visual and biochemical scores of hirsutism in PCOS patients and (2) to determine a cutoff score for the visual scoring of hirsutism among Filipinos.

This is a cross-sectional study done in a tertiary hospital. Ethical approval was obtained for this study. Patients who satisfied the inclusion criteria were included in the study. Age, height, weight, body mass index (BMI), and OB score were noted. Visual scoring for hirsutism using the mFG scoring system was performed. Blood extraction was done for testosterone and sex hormone-binding globulin tests. FAI was then computed and correlated with the mFG scores.

A total of 52 patients were identified. A positive correlation is noted between the mFG with testosterone and FAI. A positive correlation was also noted between the BMI with testosterone and FAI. An mFG value of >4 is an acceptable cutoff for Filipinos.

The study showed as the mFG score increases, FAI and tT levels also increase. It was also noted that as BMI increases, the FAI and tT levels are also expected to increase. It can also be concluded that a lower mFG cutoff value, >4, is applicable for Filipinos.

Hypertrichosis refers to the increase of hair density or length beyond the accepted limits of normal for a particular age, race, or sex. It is an overgrowth of hair in androgen-independent areas and it differs from hirsutism, which refers to hair growth in women in areas of the body where hair growth is under androgen control. It may be classified into congenital and acquired types according to age of development, and localized or generalized types according to the range of involvement. Acquired localized hypertrichosis may occur secondary to infective or inflammatory diseases, traumas, drugs, fracture and cast, lymphedema, sympathetic dystrophy, topical steroid application, denervation, or congenital AV fistula. Any situation that results in persistent and repetitious inflammation in the dermis or individual susceptibility may cause hypertrichosis. We report two cases of acquired localized hypertrichosis associated with cellulitis and contusion.
Cellulitis* ; Continental Population Groups ; Contusions* ; Denervation ; Dermis ; Female ; Fistula ; Hair ; Hirsutism ; Humans ; Hypertrichosis* ; Inflammation ; Lymphedema

OBJECTIVE: To investigate the relationship between serum dehydroepiandrosterone sulfate (DHEAS) or free testosterone (FT) levels and aging. METHODS:One hundred and thirty one women without androgen excess symptoms such as oligomenorrhea or amenorrhea or hirsutism were recruited for measuring serum DHEAS, FT levels by radioimmunoassay. A P-value <0.05 was considered to be significant statistically. RESULTS: The levels of DHEAS were 211.39+/-33.01 microg/dL (twenties, n=10), 127.99+/-11.79 microg/dL (thirties, n=31), 94.30+/-7.49 microg/dL (forties, n=57) and 71.79+/-5.71 microg/dL (over fifties, n=33) respectively (mean+/-SE, P<0.001). The levels of FT were 3.98+/-0.94 pg/ml (twenties, n=10), 3.37+/-0.47 pg/mL (thirties, n=31), 2.68+/-0.30 pg/mL (forties, n=57) and 1.97+/-0.28 pg/mL (fifties, n=33) respectively (mean+/-SE, P=0.030). Mean value declining of DHEAS (r=-0.48865, P<0.0001) was bigger than those of FT (r=-0.29334, P<0.0007). CONCLUSION: Both DHEAS and FT levels decline with age and DHEAS decreases more steeply than FT.
Aging ; Amenorrhea ; Dehydroepiandrosterone ; Dehydroepiandrosterone Sulfate ; Female ; Hirsutism ; Humans ; Oligomenorrhea ; Radioimmunoassay ; Testosterone

OBJECTIVE: To investigate the relationship between serum dehydroepiandrosterone sulfate (DHEAS) or free testosterone (FT) levels and aging. METHODS:One hundred and thirty one women without androgen excess symptoms such as oligomenorrhea or amenorrhea or hirsutism were recruited for measuring serum DHEAS, FT levels by radioimmunoassay. A P-value <0.05 was considered to be significant statistically. RESULTS: The levels of DHEAS were 211.39+/-33.01 microg/dL (twenties, n=10), 127.99+/-11.79 microg/dL (thirties, n=31), 94.30+/-7.49 microg/dL (forties, n=57) and 71.79+/-5.71 microg/dL (over fifties, n=33) respectively (mean+/-SE, P<0.001). The levels of FT were 3.98+/-0.94 pg/ml (twenties, n=10), 3.37+/-0.47 pg/mL (thirties, n=31), 2.68+/-0.30 pg/mL (forties, n=57) and 1.97+/-0.28 pg/mL (fifties, n=33) respectively (mean+/-SE, P=0.030). Mean value declining of DHEAS (r=-0.48865, P<0.0001) was bigger than those of FT (r=-0.29334, P<0.0007). CONCLUSION: Both DHEAS and FT levels decline with age and DHEAS decreases more steeply than FT.
Aging ; Amenorrhea ; Dehydroepiandrosterone ; Dehydroepiandrosterone Sulfate ; Female ; Hirsutism ; Humans ; Oligomenorrhea ; Radioimmunoassay ; Testosterone

Polycystic ovary syndrome (PCOS) is a common disorder of premenopausal women, affecting 4 to 8% of this population. Diagnosis of PCOS lays on a combination of clinical, biological and ultrasound criteria that has been used variably worldwide. The phenotype of women with PCOS is variable depending on ethnic background and diagnostic criteria may rely on it. Fewer studies have extensively examined reproductive and metabolic characteristics and hyperandrogenism in Korean women. Despite the paucity of these studies, they are critical for the ascertainment of criteria for the diagnosis of PCOS. This review address the issues pertaining to diagnostic issues of PCOS in Korean women, specifically: reproductive and metabolic derangements and criteria for hyperandrogenism based on hirsutism and serum androgen concentrations. The prevalence (estimated) of PCOS in Korean women was 5.8%. To diagnose PCOS, the cut off value for hirsutism needs to be differently adjusted in Korean women. Regarding phenotypic characteristics of PCOS in Korean women, the various phenotypes of PCOS have the different overall morbidity (e.g. insulin resistance and hyperinsulinism, abnormal glucose metabolism and metabolic syndrome). Especially patients with oligomenorrhea/polycystic ovary and hyperandrogenism/polycystic ovary did not seem to have metabolic derangements. Thus these subgroups need to be determined if they can be classified as PCOS.
Female ; Glucose ; Hirsutism ; Humans ; Hyperandrogenism ; Hyperinsulinism ; Insulin Resistance ; Ovary ; Phenotype ; Polycystic Ovary Syndrome ; Prevalence

Hyperandrogenism refers to classical androgen-dependent signs such as hirsutism, acne and androgenetic alopecia. Disorders that result in androgen excess include specific identifiable disorders (i.e. disorders of inclusion), but the great majority of women presenting with hirsutism and other symptoms or signs of hyperandrogenism suffer from polycystic ovary syndrome (PCOS). Hirsutism is the main hyperandrogenic symptom, defined as an excess of body hair in androgen-sensitive regions of skin in women. In this review, I attempt to focus on the pathogenesis of hirsutism, as well as clinical and biochemical features that are important in choosing therapeutic options. PCOS is the most common disorder of premenopausal women, affecting 4 to 8% of this population, and therefore, diagnostic issues of PCOS in Korean women will be addressed, specifically the reproductive and metabolic derangements and criteria for hyperandrogenism based on hirsutism and serum androgen concentrations.
Acne Vulgaris ; Alopecia ; Female ; Hair ; Hirsutism ; Humans ; Hyperandrogenism ; Polycystic Ovary Syndrome ; Skin

The SAHA syndrome is an acronym which stands for seborrhea, acne, hirsutism and androgenic alopecia. The SAHA syndrome generally occurs in young to middle-aged women and may be caused by elevated blood levels of androgens or increased androgen-driven peripheral response with normal circulating androgen levels. In SAHA syndrome, careful diagnostic and clinical evaluation is necessary in order to identify the cause of peripheral hyperandrogenism, and to exclude androgen-producing tumors. SAHA can be classified into 5 subtypes: familial, ovarian, adrenal, hyperprolactinemic SAHA and HAIRAN (hyperandrogenism, insulin resistance, acanthosis nigricans) syndrome. Among them, ovarian SAHA syndrome is associated with polycystic ovarian syndrome. We report a case of ovarian SAHA syndrome in 15-year-old girl who showed seborrea, acne, hirsutism and androgenic alopecia associated with polycystic ovarian syndrome.
Acne Vulgaris ; Adolescent ; Alopecia ; Androgens ; Dermatitis, Seborrheic ; Female ; Hirsutism ; Humans ; Hyperandrogenism ; Insulin Resistance ; Polycystic Ovary Syndrome