Evidence-based approach to cutaneous hyperandrogenism in women - 14/09/15
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Abstract |
Hirsutism, acne, and androgenetic alopecia are classically considered signs of cutaneous hyperandrogenism (CHA). These common skin findings have significant impacts on the quality of patients' lives and pose the diagnostic challenge of excluding underlying disorders. Many with CHA have normal serum androgen levels. Hirsutism is more strongly associated with hyperandrogenism than are acne or androgenetic alopecia. Variable association of CHA with hyperandrogenemia results from the complexity of the underlying pathophysiology, including factors local to the pilosebaceous unit. CHA often occurs in the setting of polycystic ovary syndrome, the most common disorder of hyperandrogenism, but can also present in uncommon conditions, including nonclassic adrenal hyperplasia and androgen-producing tumors. A thorough history and full skin examination are important to guide appropriate diagnostic evaluation. Oral contraceptive pills with or without antiandrogens can provide therapeutic benefit for hirsutism and acne. Medical options for androgenetic alopecia remain limited. Multidisciplinary approaches may be needed given endocrine, metabolic, reproductive, and psychiatric disorders associated with CHA. More high-quality studies into the mechanisms of CHA and the benefits of antiandrogenic therapies are needed. We provide an evidence-based review of key diagnostic and therapeutic considerations in the treatment of women with CHA.
Le texte complet de cet article est disponible en PDF.Key words : acne, androgenetic alopecia, androgenic alopecia, antiandrogen, combined oral contraceptive, female pattern hair loss, hirsutism, hyperandrogenemia, polycystic ovary syndrome, spironolactone
Abbreviations used : AGA, CHA, COC, PCOS, RCT
Plan
Supported by the University of California San Francisco Medical Scientist Training Program (Dr Schmidt) and a Medical Dermatology Career Development Award (2010-2013) sponsored by the Dermatology Foundation (Dr Shinkai). |
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Conflicts of interest: None declared. |
Vol 73 - N° 4
P. 672-690 - octobre 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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