Hirsutism history and symptoms: Difference between revisions

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{{Hirsutism}}
{{Hirsutism}}
{{CMG}} {{AE}}; {{Ochuko}} {{RHN}}
{{CMG}} {{AE}} {{Ochuko}} {{RHN}}, {{AY}}


==Overview==
==Overview==
Hirsutism affects members of any gender, since rising androgen levels can cause excessive body hair, particularly in locations where women normally do not develop terminal hair during puberty (chest, abdomen, back, and face). Signs that are suggestive of an androgen-secreting tumor in a patient with hirsutism is rapid onset, virilization and palpable abdominal mass.
The hallmark of hirsutism is excessive facial hair growth. A positive history of virilizing symptoms is suggestive of an underlying hormonal imbalance. The most important points in history taking regarding hirsutism in patients include: Age of onset, family history, and severity/progression.  


==History and Symptoms==
==History and Symptoms==
===History===
===History===
A good and accurate history of the onset and developmental [[milestones]] are important and useful in making a diagnosis of hirsutism.
* A good and accurate history of the onset and developmental [[milestones]] are important and useful in making a diagnosis of hirsutism.<ref name="pmid3396696">{{cite journal |vauthors=Ruutiainen K, Erkkola R, Grönroos MA, Irjala K |title=Influence of body mass index and age on the grade of hair growth in hirsute women of reproductive ages |journal=Fertil. Steril. |volume=50 |issue=2 |pages=260–5 |year=1988 |pmid=3396696 |doi= |url=}}</ref>
*'''Age of Onset'''
**During [[puberty]], idiopathic hirsutism and other less serious causes of hirsutism usually begins.
**Hirsutism in middle-aged or older women may suggest an adrenal or [[ovarian tumor]].


*'''Family History''': [[Congenital adrenal hyperplasia (CAH)]] in a patient with a family history of hirsutism is consistent with the diagnosis. [[Idiopathic]] hirsutism and [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]] could also be familial and maybe suggestive in making a diagnosis.
==== '''Age of Onset''' ====
*During [[puberty]]
**Mainly due to idiopathic hirsutism and other less serious causes of hirsutism
*Hirsutism in middle-aged or older women
**May suggest an adrenal or [[ovarian tumor]]


*'''Hirsutism severity and rate of progression'''
==== '''Family History''' ====
**A benign form of hirsutism is usually characterized by [[pubertal]] onset with slow progression over many years. This is often true of hirsutism with [[PCOS]].
* [[Congenital adrenal hyperplasia (CAH)]] in a patient with a family history of hirsutism is consistent with the diagnosis. [[Idiopathic]] hirsutism and [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]] could also be familial and may be suggestive in making a diagnosis.
**An androgen-secreting tumor is a possibility with a history of rapid severe hirsutism or other signs of [[virilization]].  


==== '''Hirsutism severity and rate of progression''' ====
*A benign form of hirsutism is usually characterized by [[pubertal]] onset with slow progression over many years. This is often true of hirsutism with [[PCOS]].
*An androgen-secreting tumor is a possibility with a history of rapid severe hirsutism or other signs of [[virilization]].
*'''[[Adrenarche]] and [[Puberty]]''': Early development of pubic hair is a pointer towards [[CAH]].
*'''[[Adrenarche]] and [[Puberty]]''': Early development of pubic hair is a pointer towards [[CAH]].
 
===Common Symptoms===
===Symptoms===
*Patients must be assessed regarding the presence or lack of [[virilizing]] signs such as:<ref name="pmid20418968">{{cite journal |vauthors=Sachdeva S |title=Hirsutism: evaluation and treatment |journal=Indian J Dermatol |volume=55 |issue=1 |pages=3–7 |year=2010 |pmid=20418968 |pmc=2856356 |doi=10.4103/0019-5154.60342 |url=}}</ref>
*[[Virilizing]] signs such as;
**Change in the voice or deepening voice
**Change in voice or deepening voice
**[[Male pattern baldness]]
**[[Male pattern baldness]]
**Excess facial and body hair
**Excess facial and body hair
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**Increased muscle mass
**Increased muscle mass
**[[Acne]]
**[[Acne]]
**Decreased breast size (small breasts)
**Decreased breast size
*[[Amenorrhea]]
*[[Amenorrhea]]
*Increase in [[libido]]
*Increased [[libido]]
*Signs of [[insulin]] resistance (eg. [[acanthosis nigricans]], abdominal obesity)
*Signs of [[insulin]] resistance (eg, [[acanthosis nigricans]], abdominal obesity)
 
=== Less Common Symptoms ===
*


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Needs content]]
[[Category:Endocrinology]]
[[Category:Integumentary system]]
[[Category:Gynecology]]
[[Category:Dermatology]]
[[Category:Hair-related diseases]]
{{WH}}
{{WS}}

Latest revision as of 15:22, 8 December 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2] Rasam Hajiannasab M.D.[3], Ahmed Younes M.B.B.CH [4]

Overview

The hallmark of hirsutism is excessive facial hair growth. A positive history of virilizing symptoms is suggestive of an underlying hormonal imbalance. The most important points in history taking regarding hirsutism in patients include: Age of onset, family history, and severity/progression.

History and Symptoms

History

  • A good and accurate history of the onset and developmental milestones are important and useful in making a diagnosis of hirsutism.[1]

Age of Onset

  • During puberty
    • Mainly due to idiopathic hirsutism and other less serious causes of hirsutism
  • Hirsutism in middle-aged or older women

Family History

Hirsutism severity and rate of progression

  • A benign form of hirsutism is usually characterized by pubertal onset with slow progression over many years. This is often true of hirsutism with PCOS.
  • An androgen-secreting tumor is a possibility with a history of rapid severe hirsutism or other signs of virilization.
  • Adrenarche and Puberty: Early development of pubic hair is a pointer towards CAH.

Common Symptoms

Less Common Symptoms

References

  1. Ruutiainen K, Erkkola R, Grönroos MA, Irjala K (1988). "Influence of body mass index and age on the grade of hair growth in hirsute women of reproductive ages". Fertil. Steril. 50 (2): 260–5. PMID 3396696.
  2. Sachdeva S (2010). "Hirsutism: evaluation and treatment". Indian J Dermatol. 55 (1): 3–7. doi:10.4103/0019-5154.60342. PMC 2856356. PMID 20418968.