Clinico-pathological correlation in Indian women presenting with cutaneous features of hyperandrogenism: A cross-sectional study

Abstract

Background: Androgen excess is one of the most common endocrine disorders of reproductive-aged women, which can present in the form of hirsutism, androgenic alopecia, acne, ovulatory dysfunction, and if extreme and prolonged, even virilization. It is important to diagnose the underlying abnormality in young women presenting with cutaneous signs of hyperandrogenism so that appropriate treatment can be offered and long-term consequences of androgen excess in young females such as ovulatory dysfunction and infertility can be avoided besides improving the cosmetic appearance. Aims: The aim of this study was to study the cutaneous manifestations of hyperandrogenism and the various underlying clinicopathological conditions. Settings and Design: The study design was a cross-sectional descriptive study. Materials and Methods: One hundred women patients of reproductive age were studied for clinical manifestations of hyperandrogenism (excess hair growth, seborrhea, acne, alopecia, and/or menstrual disturbances), hormone levels, radioimaging, and underlying endocrinological diagnosis. Statistical Analysis Used: The data were analyzed with CDC EPI Info software computer program (version 7.2) using the appropriate statistical techniques. Results: A majority of 55% of cases were in the third decade. A family history of hirsutism was present in 8% of cases. Menstrual dysfunction was present in 50%. Seborrhea was present in 93%, acne in 71%, hirsutism in 91%, alopecia in 62%, and altogether were present in 39%. Biochemical evidence of hyperandrogenism was present in 75% and correlated with the severity of the grade of hirsutism. Polycystic ovarian syndrome (PCOS) was the most common underlying condition in 72% followed by idiopathic hirsutism in 13%. Conclusions: The present study shows PCOS as the most common underlying cause of cutaneous manifestations of hyperandrogenism. The severity of hirsutism correlates with serum testosterone levels.

Keywords

• hirsutism
• hyperandrogenic-insulin-resistant-acanthosis nigricans syndrome
• hyperandrogenism
• idiopathic hirsutism
• nonclassical adrenal hyperplasia
• polycystic ovarian syndrome