Chapter 050. Hirsutism and Virilization (Part 1) pptx

Hirsutism and Virilization Part 1 Harrison's Internal Medicine > Chapter 50.. Hirsutism and Virilization Hirsutism and Virilization: Introduction Hirsutism, defined as excessive male-

Chapter 050 Hirsutism and

Virilization

(Part 1)

Harrison's Internal Medicine > Chapter 50 Hirsutism and Virilization

Hirsutism and Virilization: Introduction

Hirsutism, defined as excessive male-pattern hair growth, affects

approximately 10% of women It usually represents a variation of normal hair growth, but rarely it is a harbinger of a serious underlying condition Hirsutism is often idiopathic but may be caused by conditions associated with androgen excess, such as polycystic ovarian syndrome (PCOS) or congenital adrenal hyperplasia (CAH) (Table 50-1) Cutaneous manifestations commonly associated with hirsutism include acne and male-pattern balding (androgenic alopecia)

Virilization refers to a condition in which androgen levels are sufficiently high to

cause additional signs and symptoms such as deepening of the voice, breast atrophy, increased muscle bulk, clitoromegaly, and increased libido; virilization is

an ominous sign that suggests the possibility of an ovarian or adrenal neoplasm

Table 50-1 Causes of Hirsutism

Gonadal hyperandrogenism

Ovarian hyperandrogenism

Polycystic ovary syndrome/functional ovarian hyperandrogenism

Ovarian steroidogenic blocks

Syndromes of extreme insulin resistance

Ovarian neoplasms

Adrenal hyperandrogenism

Premature adrenarche

Functional adrenal hyperandrogenism

Congenital adrenal hyperplasia (nonclassic and classic)

Abnormal cortisol action/metabolism

Adrenal neoplasms

Other endocrine disorders

Cushing's syndrome

Hyperprolactinemia

Acromegaly

Peripheral androgen overproduction

Obesity

Idiopathic

Pregnancy-related hyperandrogenism

Hyperreactio luteinalis

Thecoma of pregnancy

Drugs

Androgens

Oral contraceptives containing androgenic progestins

Minoxidil

Phenytoin

Diazoxide

Cyclosporine

True hermaphroditism