April 8, 2018

Hirsutism

Hirsutism

Hirsutism is a condition in which woman experienced male pattern growth seen in females of all ages. It affects around 5-10% of the women and is a common presenting complaint for cosmetic reasons.  Hyperandrogeneism, is the main cause may be ovarian or adrenal. Metabolic syndrome, drug induced & idiopathic may be the rare cause.

Females experienced increased growth of terminal hair at sides of the face, upper lip, chin, upper back, shoulders & sternum.

Polycystic ovarian syndrome (PCOS) and ovarian tumors are the ovarian cause.

Cushing’s syndrome, androgen-producing tumors, and congenital adrenal hyperplasia (CAH), most commonly due to 21-hydroxylase deficiency are the adrenal causes.

Hyperandrogenic-insulin resistant-acanthosis nigricans syndrome (HAIRAN) & Hyperprolactinemia by increasing adrenal dihydroepiandrosterone sulfate (DHEA-S) production may cause hirsutism.

 

Detailed examination and proper history must be needed for the clinical diagnosis & the test adviced are

    1. Testosterone levels
    2. Dehydroepiandrosterone sulfate (DHEAS) levels
    3. 17 Hydroxy progesterone
    4. Twenty four hour urine free cortisol levels
    5. LH/FSH ratio
    6. Prolactin
    7. Serum TSH
  2. Pelvic ultrasonography
  3. Magnetic resonance imaging (MRI) or computed tomography (CT) of the adrenal region.

Oral contraceptives

Oral contraceptives (OCP) are first-line treatment

Spironolactone, Cyproterone Acetate, Eflornithine hydrochloride cream, Glucocorticoids etc..

 

Laser is the ultimate therapy to reduce the growth.

laser used commonly are Diode, NdYAG, IPL.

 

Electrolysis is again an another choice.

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Fames amet, amet elit nulla tellus, arcu.

Ichthyosis (ick-thee-OH-sis) is a skin disease that causes extremely dry, thick, and scaly skin resembles fish scales.

These are a heterogeneous group of disorders with both inherited and acquired forms. these are the types
Ichthyosis Vulgaris- Most common type of icthyosis Lamellar Ichthyosis- Lamellar ichthyosis is characterized by dark, plate (armor)-like scale. Epidermolytic Hyperkeratosis- characterized by generalized redness and fine white scale Congenital Ichthyosiform Erythroderma- newborn infant with ichthyosis who presented at birth with collodion baby appearance. X-linked Ichthyosis- due to a defect in the enzyme steroid sulfatase, affects males with generalized scaling that usually begins soon after birth.

Ichthyosis Treatment

Several hours each day may need to be devoted the skin if ichthyosis is present in an individual. Daily, a person will need to take a shower or a bath. The skin should be exfoliated on a daily basis, and moisturised well. Moisturising ointments or creams may need to be prescribed by a dermatologist for the individual. Oral retinoids can be prescribed to reduce scaling. If a secondary infection occurs on the skin, oral antibiotics will need to be prescribed. Tips that will help keep the skin looking and feeling its best include applying a good quality lotion within 3 minutes of bathing. Apply to wet skin to keep moisture trapped into the skin. Products that contain lactic acid, alpha hydroxy acids and urea will help to keep skin not only moisturised but also exfoliated. Rubbing a wet pumice stone over crusty scales on the skin can help to remove them. Should there be scales on the scalp, brushing wet hair gently will aid in removing the scales.  

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