Hirsutism

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Appearance and evaluation

Hirsutism only affects women, since the rising of androgens causes a male pattern of body hair, particularly in locations where women normally do not develop terminal hair within their puberty (chest, abdomen, back and face). The medical term for excessive hair growth that affect both men and women is hypertrichosis.

One method of evaluating hirsutism is the Ferriman-Gallwey score which gives a score based on the amount and location of hair growth on a woman.

Differential Diagnosis of Causes of Hirsutism

1. Idiopathic:
   • familial,
   • possibly increased sensitivity to androgens.
2. variant of normal menopause.
3. Polycystic ovarian syndrome.
4. obesity
5. Drugs:
   • androgens,
   • anabolic steroids,
   • methyltestosterone,
   • minoxidil,
   • diazoxide,
   • phenytoin,
   • glucocorticoids,
   • cyclosporine.
   • phenytoin,
6. Congenital adrenal hyperplasia.
7. Adrenal virilizing tumor.
8. Ovarian virilizing tumor:
   • arrhenoblastoma,
   • hilus cell tumor.
9. Pituitary adenoma.
10. pregnancy
11. Insulin resistance
12. Cushing's syndrome.
13. Hypothyroidism (congenital and juvenile).
14. Acromegaly.
15. Androgen-secreting tumors of the ovaries
    • Sertoli-Leydig cell tumors,
    • granulosa-theca cell tumors,
    • hilus-cell tumors
16. hyperprolactinemia
17. Testicular feminization.

Related Chapters

• Androgenic hair
• Hypertrichosis
• Hair removal

References

• Ferriman D, Gallwey JD: Clinical assessment of body hair growth in women. Journal of Clinical Endocrinology 1961; 21:1440-1447.

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