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Nawar M, Mohammad MS, Shabaan A, Elsedfy H. Ovarian reserve and fertility parameters in post-pubertal females with congenital adrenal hyperplasia: a case-control study. J Pediatr Endocrinol Metab 2024; 37:336-340. [PMID: 38459773 DOI: 10.1515/jpem-2023-0462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/18/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder characterized by impaired activity of the enzyme required for cortisol and aldosterone production, resulting in increased adrenal androgen synthesis. Factors affecting fertility in CAH patients include ambiguous genitalia and their complications, excessive androgen secretion, adrenal progesterone hypersecretion, and various psychosocial factors. Serum anti-Müllerian hormone (AMH) level is used to assess ovarian reserve in women. A few data on serum AMH levels in CAH patients are available in the literature. The aim of the study was to evaluate ovarian reserve in a group of post-menarche females diagnosed with CAH by measuring serum AMH level and assessing the number of antral follicles sonographically. METHODS A case-control study was conducted on 17 post-pubertal CAH females and 17 age-matched healthy female controls; the mean age of the patient group was 15.09 ± 3.55 years ranging from 11 to 24 years, while the mean age of the control group was 16.04 ± 3.72 years ranging from 12 to 25 years, the mean post-menarchal age of the patients group was 3.29 ± 1.37 years ranging from 1 to 6 years while the mean post-menarchal age of the control group was 4.13 ± 1.62 years ranging from 1 to 9 years. The degree of hirsutism was compared between the two groups according to the modified Ferriman-Gallwey score, clitoral length was assessed using a digital caliber. Serum levels of adrenal androgens in addition to basal levels of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, and serum AMH were measured in both groups. RESULTS Patients had smaller uterine volumes, and smaller ovarian volumes but a comparable number of antral follicles and comparable serum AMH levels relative to controls. CONCLUSIONS Good compliance with treatment in patients with CAH results in good hormonal control, low risk of PCOS, good fertility parameters, and a good ovarian reserve.
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Affiliation(s)
- Marwa Nawar
- Pediatric Endocrinology Clinic,Pediatrics department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Asmaa Shabaan
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba Elsedfy
- Pediatric Endocrinology Clinic,Pediatrics department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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2
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Krasniqi A, McClurg DP, Gillespie KJ, Rajpara S. Efficacy of lasers and light sources in long-term hair reduction: a systematic review. J COSMET LASER THER 2022; 24:1-8. [DOI: 10.1080/14764172.2022.2075899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A. Krasniqi
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - D. P. McClurg
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - K. J. Gillespie
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - S. Rajpara
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
- Department of Dermatology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK
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3
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de Kroon RW, den Heijer M, Heijboer AC. Is idiopathic hirsutism idiopathic? Clin Chim Acta 2022; 531:17-24. [DOI: 10.1016/j.cca.2022.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 01/12/2023]
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4
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LeVee A, Suppogu N, Walsh C, Sacks W, Simon J, Shufelt C. The Masquerading, Masculinizing Tumor: A Case Report and Review of the Literature. J Womens Health (Larchmt) 2020; 30:1047-1051. [PMID: 32991246 DOI: 10.1089/jwh.2020.8548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Androgen-producing tumors in women are rare neoplasms that can cause secondary virilizing characteristics. Of patients presenting with symptoms of hyperandrogenism, these tumors are found in ∼0.2% of cases. Androgen-producing tumors can arise from the ovary or the adrenal gland. Those arising from the ovary are rare, accounting for <5% of all ovarian tumors. This case presents a hilar Leydig cell tumor of the ovary, which resulted in secondary virilization of a 45-year-old female 2 months after cessation of combined oral contraceptives (COC). Laboratory findings showed markedly elevated total and free testosterone concentrations with normal dehydroepiandrosterone sulfate, however neither pelvic ultrasound nor magnetic resonance imaging demonstrated any masses. Venous sampling under fluoroscopy revealed supraphysiologic testosterone concentrations from the right ovarian vein suggesting the source. The patient underwent bilateral salpingo-oophorectomy revealing a 1.3 cm hilar cell tumor of the right ovary. This article reviews the clinical features, diagnosis, and treatment of hilar Leydig cell tumors and describes the long-term complications of supraphysiologic testosterone levels. As the tumor presented after cessation of COC, we also review the mechanisms by which COC might suppress supraphysiologic androgen levels and mask the secondary virilizing effects of androgen-producing tumors.
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Affiliation(s)
- Alexis LeVee
- Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Nissi Suppogu
- Barbra Streisand Women's Heart Center, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California, USA
| | - Christine Walsh
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Wendy Sacks
- Department of Endocrinology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - James Simon
- IntimMedicine Specialists, Department of Obstetrics and Gynecology, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Chrisandra Shufelt
- Barbra Streisand Women's Heart Center, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California, USA
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5
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Moubasher AEA, Abdel Basset HA, Khalil AAM, Youssef EMK. Levonorgestrel vs combined oral contraceptive pills in treatment of female acne and hirsutism. Dermatol Ther 2020; 33:e13700. [PMID: 32713062 DOI: 10.1111/dth.13700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 04/25/2020] [Accepted: 05/16/2020] [Indexed: 12/01/2022]
Abstract
Combined oral contraception was used in many studies for treatment of acne and hirsutism. However, levonorgestrel (LNG) alone has not been evaluated before. Our objective is to evaluate the efficacy of oral contraceptive (OC) pills containing LNG and ethinyl estradiol (EE) compared with LNG only for the treatment of acne and hirsutism in a randomized, controlled prospective clinical trial. Eighty females (20 with acne, 20 with hirsutism, and 40 healthy females) received LNG + EE or LNG only for 6 months. Assessment of acne by global acne grading system (GAGS) and hirsutism by modified Ferriman-Gallwey scale (MFGS) grading system and serum free testosterone was measured before and 6 months after treatment. Serum free testosterone was significantly higher before treatment in acne and hirsutism patients compared to control group (P < .000). In acne patients, after 6 months of treatment with LNG/EE, serum free testosterone, and (GAGS), were significantly decreased compared to LNG only (P < .000). In hirsutism group, after 6 months of treatment with LNG/EE, serum free testosterone and (MFGS), were nonsignificantly decreased compared to LNG only. OCs containing either LNG/EE or LNG seem to be effective and safe treatment for acne and hirsutism.
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Affiliation(s)
- Alaa E A Moubasher
- Department of Dermatology, Venerology and Andrology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hisham A Abdel Basset
- Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | - Eman M K Youssef
- Department of Dermatology, Venerology and Andrology, Faculty of Medicine, Assiut University, Assiut, Egypt
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Kenawi MZ, Akl EM, Sabry JH, Mostafa ST. Evaluation of serum level of omentin-1 in females with hirsutism. J Cosmet Dermatol 2019; 19:535-539. [PMID: 31190433 DOI: 10.1111/jocd.13043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 05/03/2019] [Accepted: 05/20/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hirsutism is a common clinical condition encountered in day-to-day practice. The androgenic causes account for more than 80% of these patients and include polycystic ovary syndrome (PCOS), which affects about 70%-80% of hirsute women. The second most common cause is idiopathic hirsutism. Omentin-1 is an adipokine mainly produced by visceral adipose tissue. AIM The current study aimed at evaluating omentin-1 levels in hirsute females with PCOS and in idiopathic hirsutism. PATIENTS AND METHODS Eighty-five females were included in this study. They were classified into three groups: thirty hirsute patients with PCOS, thirty females with idiopathic hirsutism, and twenty-five healthy control females. The participants were subjected to history taking, physical and dermatological examination. A gynecological history and radiological examination of the ovary also were done. Serum testosterone and omentin-1 were measured by ELISA. RESULTS Serum testosterone was statistically elevated in PCOS than other groups. Serum omentin-1 in females with idiopathic hirsutism was statistically significantly higher than control and PCOS. There was a significant inverse correlation between serum testosterone level and serum omentin-1 level. CONCLUSION Omentin-1 may be involved in the pathogenic process of hirsutism.
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Affiliation(s)
- Mohammed Z Kenawi
- Department of Dermatology, Venereology & Andrology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Essam M Akl
- Department of Dermatology, Venereology & Andrology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Jehan H Sabry
- Department of Clinical Pathology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Sara T Mostafa
- Department of Obstetric & Gynecology, Faculty of Medicine, Benha University, Benha, Egypt
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Gainder S, Sharma B. Update on Management of Polycystic Ovarian Syndrome for Dermatologists. Indian Dermatol Online J 2019; 10:97-105. [PMID: 30984582 PMCID: PMC6434760 DOI: 10.4103/idoj.idoj_249_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Polycystic ovarian syndrome (PCOS) is the commonest endocrine disorder in women having wide range of clinical manifestation. These women may present with reproductive, dermatological, metabolic, psychological, or neoplastic implications from adolescence to menopause. The common dermatological manifestations include hirsutism, acne, alopecia, or acanthosis nigricans. Women presenting with these dermatological manifestations must be evaluated for PCOS. A multidisciplinary team approach involving a reproductive endocrinologist, dermatologist, psychologist/psychiatrist, dietician, and sometimes a bariatric surgeon should be undertaken for long-term management of these patients. Unless metabolic and underlying endocrinal disturbances arecorrected and simultaneous life-style modification is adopted, cosmetic treatment would give only temporary relief.
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Affiliation(s)
- Shalini Gainder
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bharti Sharma
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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8
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Diebo BG, Shah NV, Pivec R, Naziri Q, Patel A, Post NH, Assi A, Godwin EM, Lafage V, Schwab FJ, Paulino CB. From Static Spinal Alignment to Dynamic Body Balance: Utilizing Motion Analysis in Spinal Deformity Surgery. JBJS Rev 2018; 6:e3. [DOI: 10.2106/jbjs.rvw.17.00189] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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9
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Alijanpour R, Aliakbarpour F. A randomized clinical trial on the comparison between hair shaving and snipping prior to laser hair removal sessions in women suffering from hirsutism. J Cosmet Dermatol 2016; 16:70-75. [PMID: 27616192 DOI: 10.1111/jocd.12280] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Hirsutism or excess hair growth is a common dermatological problem in females, affecting up to 10% of females worldwide. We aimed this study to compare the two hair-shortening methods shaving vs. snipping among hirsute women regarding the outcome of the therapy and also the paradoxical hypertrichosis phenomenon (terminal hair regrowth) 6 months after the final therapy session. MATERIALS AND METHODS In this study, 129 premenopausal women affected by hirsutism were randomly divided into two study groups according to hair-shortening method: shaving as group A (66 patients) and hair shortening by scissor as group B (63 patients). Each patient received six alexandrite laser therapy sessions every month for six consecutive months. Chin hairs in a 5 × 5 cm2 zone were counted, and the paradoxical hair regrowth was evaluated four times during the study: once at baseline, once before the third session, once before the sixth session, and once 6 months after the last laser session. RESULTS Before the third session, the counts were 15.06 ± 5.20 in group A and 13.07 ± 4.44 in group B (P = 0.022); both counts were meaningfully less than the baseline count (P < 0.001). The counts before the sixth session were 2.80 ± 1.16 in group A and 2.71 ± 1.12 in group B (P = 0.673); the counts were significantly lower than the previous session (P < 0.001). Six months after the last laser session, the counts were 11.27 ± 9.30 in group A and 8.15 ± 3.12 in group B (P = 0.012). Paradoxical hypertrichosis was observed in three patients of group A vs. no patients in group B. CONCLUSION We found that alexandrite laser therapy is really effective for treating hirsutism. Both shaving and using a scissor for hair shortening showed similar short-term results, but in one-year follow-up, paradoxical hypertrichosis was only observed in shaving group and also a lower hair count was observed in the snipping group.
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10
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Moirano G, Zugna D, Grasso C, Lista P, Ciuffreda L, Segnan N, Merletti F, Richiardi L. Baldness and testicular cancer: the EPSAM case-control study. Andrology 2016; 4:251-6. [PMID: 26941123 DOI: 10.1111/andr.12148] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 10/28/2015] [Accepted: 11/16/2015] [Indexed: 11/29/2022]
Abstract
The etiology of testicular cancer is largely unexplained. Research has mainly focused on prenatal exposures, especially to sex hormones, while less attention has been paid to exposures that may act also postnatally. As baldness has been previously associated with testicular cancer risk we focused on baldness and body hairiness, which are both associated with androgen activity. We used data of the Postnatal Exposures and Male Health (EPSAM) study, a case-control study on testicular cancer conducted in the Province of Turin, Italy, involving cases diagnosed between 1997 and 2008. Information was collected using mailed questionnaires. Analyses included 255 cases and 459 controls. We calculated ORs and 95% CIs to estimate testicular cancer risk among those who developed baldness and among those with body hairiness. We found an inverse association between testicular cancer and baldness (OR: 0.67, 95% CI: 0.46-0.98) and body hairiness (OR: 0.78, 95% CI: 0.53-1.16), although the latter had wider CIs. The inverse association between baldness and testicular cancer is consistent with the results from previous studies. These results suggest that androgens activity may influence testicular cancer risk.
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Affiliation(s)
- G Moirano
- Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
| | - D Zugna
- Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
| | - C Grasso
- Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
| | - P Lista
- Medical Oncology Division 1, University Hospital 'Citta' della Salute e delle Scienze', Turin, Italy
| | - L Ciuffreda
- Medical Oncology Division 1, University Hospital 'Citta' della Salute e delle Scienze', Turin, Italy
| | - N Segnan
- Department of Cancer Screening and Unit of Cancer Epidemiology, WHO Collaborative Center for Cancer Early Diagnosis and Screening, CPO Piedmont and University Hospital 'Citta' della Salute e della Scienza', Turin, Italy
| | - F Merletti
- Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
| | - L Richiardi
- Cancer Epidemiology Unit-CERMS, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
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11
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Al-Dhalimi MA, Kadhum MJ. A split-face comparison of facial hair removal with the long-pulsed alexandrite laser and intense pulsed light system. J COSMET LASER THER 2015; 17:267-72. [PMID: 25803567 DOI: 10.3109/14764172.2015.1027223] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Undesirable hair growth presents a significant problem for many patients. Photoepilation has become a very popular procedure in esthetic and cosmetic practice. Among the systems used are the long-pulsed alexandrite laser (755 nm) (ALX) and intense pulsed light (IPL). OBJECTIVE To compare the safety and efficacy of long-pulsed ALX and IPL for hair removal. PATIENTS AND METHODS This comparative study was carried out in the outpatient Department of Dermatology and Venereology, Al-Sadir Teaching Hospital, Al Najaf City during the period from June 2009 to July 2010. Thirty-five patients were included; thirty of them completed the study. They received six treatment sessions with the ALX on the left side of the face and IPL on the right side of face with 4-week intervals between sessions. Response to treatment on both sides of the face was assessed at 1, 3, and 6 treatment sessions. Hair-free intervals and patient's satisfaction were recorded in each visit. RESULTS After six treatment sessions, IPL-treated sides showed longer median hair-free intervals compared with ALX-treated sides. Reduction in hair counts was significantly larger on the IPL compared with that on the ALX-treated sides at 1, 3, and 6 sessions. Three patients (10%) developed postinflammatory hyperpigmentation, one of them on the left side and the others on the right side. It was more severe on the right side and both the patients were of skin type IV. Slight stinging and burning sensation at time of the treatment were recorded in all patients. All reported side effects were transient and tolerated by the patients except postinflammatory hyperpigmentation which persisted and was decreasing gradually toward the end of the study. CONCLUSIONS The results of this study suggested that IPL is more effective in reducing excessive facial hair growth, with longer hair-free intervals and greater patient satisfaction than the ALX.
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Affiliation(s)
- Muhsin A Al-Dhalimi
- a Department of Dermatology , College of Medicine, University of Kufa , Najaf , Iraq
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De Sanctis V, Soliman AT, Fiscina B, Elsedfy H, Elalaily R, Yassin M, Skordis N, Di Maio S, Piacentini G, Kholy ME. Endocrine check-up in adolescents and indications for referral: A guide for health care providers. Indian J Endocrinol Metab 2014; 18:S26-38. [PMID: 25538875 PMCID: PMC4266866 DOI: 10.4103/2230-8210.145055] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The American Academy of Pediatrics recommends that young people between the ages of 11 and 21 years should be seen annually by their pediatricians, since annual checkups can be an important opportunity for health evaluation and anticipatory guidance. Parents of infants and young children are accustomed to regularly visiting a pediatrician for their child's checkups. Unfortunately, when children reach the teen years, these annual checkups may decrease in frequency. In routine check-ups and medical office visits, particular attention should be paid to the possibility of a developmental or endocrine disorder. Early diagnosis and treatment may prevent medical complications in adulthood and foster age-appropriate development. Our purpose is to acquaint readers with the concept, based on current scientific understanding, that some endocrine disorders may be associated with a wide range of deleterious health consequences including an increased risk of hypertension and hyperlipidemia, increased risk of coronary artery disease, type 2 diabetes, significant anxiety and lack of self-esteem. Understanding the milestones and developmental stages of adolescence is essential for pediatricians and all other health providers who care for adolescents. Treating adolescents involves knowledge of a variety of medical, social and legal information; in addition, close working relationships must be established within the adolescent's network to create an effective care system. In summary, we underline the importance of a periodic endocrine checkup in adolescents in order to identify endocrine problems early and develop an approach to treatment for those patients who need help during this time. Indications for endocrine referral for professional and other healthcare providers are also included. These lists are clearly not intended to be comprehensive, but will hopefully serve as a guide for specific clinical circumstances.
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Affiliation(s)
- Vincenzo De Sanctis
- Quisisana Hospital, Pediatric and Adolescent Outpatient Clinic, Ferrara, Italy
| | - Ashraf T Soliman
- Department of Pediatrics, Division of Endocrinology, Alexandria University Children's Hospital, Alexandria, USA
| | | | - Heba Elsedfy
- Department of Pediatrics, Ain Shams University, Cairo, Egypt
| | - Rania Elalaily
- Department of Primary Health Care, AbuNakhla Hospital, Doha, Qatar
| | - Mohamed Yassin
- Department of Hematology, Alamal Hospital, Hamad Medical Center, Doha, Qatar
| | - Nicos Skordis
- Division of Pediatric and Adolescent Endocrinology, Paedi Center for Specialized Pediatrics, St George's University Medical School at the University of Nicosia, Cyprus, Italy
| | - Salvatore Di Maio
- Emeritus Consultant in Pediatrics, Santobono-Pausilipon Hospital, Naples, Italy
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Abstract
Menopause is defined as permanent irreversible cessation of menses brought by decline in ovarian follicular activity. Hormonal alteration results in various physical, psychological, and sexual changes in menopausal women. Associated dermatological problems can be classified as physiological changes, age-related changes, changes due to estrogen deficiency and due to hormone replacement therapy. Dermatosis seen due to estrogen deficiency includes Atrophic Vulvovaginitis, Vulvar Lichen Sclerosus, Dyaesthetic Vulvodynia, Hirsutism, Alopecia, Menopausal Flushing, Keratoderma Climactericum, Vulvovaginal Candidiasis. Dermatologists and gynecologists need to be familiar with the problems of menopausal women, as with increase in life expectancy, women passing through this phase is rising.
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Affiliation(s)
- Pragya A. Nair
- Department of Dermatology and Venereology, Pramukhswami Medical College, Karamsad, Gujarat, India
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Kumar A, Naguib YW, Shi YC, Cui Z. A method to improve the efficacy of topical eflornithine hydrochloride cream. Drug Deliv 2014; 23:1495-501. [PMID: 25182303 DOI: 10.3109/10717544.2014.951746] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
CONTEXT Facial hirsutism is a cosmetic concern for women and can lead to significant anxiety and lack of self-esteem. Eflornithine cream is indicated for the treatment of facial hirsutism. However, limited success rate and overall patient's satisfaction, even with a long-term and high-frequency application, leave room for improvement. OBJECTIVE The objective of this study is to test the effect of microneedle treatment on the in vitro skin permeation and the in vivo efficacy of eflornithine cream in a mouse model. MATERIALS AND METHOD In vitro permeation study of eflornithine was performed using Franz diffusion cell. In vivo efficacy study was performed in a mouse model by monitoring the re-growth of hair in the lower dorsal skin of mice after the eflornithine cream was applied onto an area pretreated with microneedles. The skin and the hair follicles in the treated area were also examined histologically. RESULTS AND DISCUSSION The hair growth inhibitory activity of eflornithine was significantly enhanced when the eflornithine cream was applied onto a mouse skin area pretreated with microneedles, most likely because the micropores created by microneedles allowed the permeation of eflornithine into the skin, as confirmed in an in vitro permeation study. Immunohistochemistry data revealed that cell proliferation in the skin and hair follicles was also significantly inhibited when the eflornithine cream was applied onto a skin area pretreated with microneedles. CONCLUSION The integration of microneedle treatment into topical eflornithine therapy represents a potentially viable approach to increase eflornithine's ability to inhibit hair growth.
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Affiliation(s)
- Amit Kumar
- a Pharmaceutics Division , College of Pharmacy, The University of Texas at Austin , Austin , TX , USA and
| | - Youssef W Naguib
- a Pharmaceutics Division , College of Pharmacy, The University of Texas at Austin , Austin , TX , USA and
| | - Yan-Chun Shi
- b Research Center of Molecular Biology, College of Basic Medical Sciences, Inner Mongolia Medical University , Hohhot , Inner Mongolia , China
| | - Zhengrong Cui
- a Pharmaceutics Division , College of Pharmacy, The University of Texas at Austin , Austin , TX , USA and.,b Research Center of Molecular Biology, College of Basic Medical Sciences, Inner Mongolia Medical University , Hohhot , Inner Mongolia , China
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15
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Ramezani Tehrani F, Minooee S, Azizi F. Validation of a simplified method to assess hirsutism in the Iranian population. Eur J Obstet Gynecol Reprod Biol 2014; 174:91-5. [DOI: 10.1016/j.ejogrb.2013.12.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 11/24/2013] [Accepted: 12/08/2013] [Indexed: 10/25/2022]
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16
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Hohl A, Ronsoni MF, Oliveira MD. Hirsutism: diagnosis and treatment. ACTA ACUST UNITED AC 2014; 58:97-107. [DOI: 10.1590/0004-2730000002923] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 11/26/2013] [Indexed: 02/01/2023]
Abstract
Hirsutism is defined as excessive terminal hair growth in androgen-dependent areas of the body in women, which grows in a typical male distribution pattern. Hirsutism is a common clinical problem in women, and the treatment depends on the cause. The condition is often associated with a loss of self-esteem. Hirsutism reflects the interaction between circulating androgen concentrations, local androgen concentrations, and the sensitivity of the hair follicle to androgens. Polycystic ovary syndrome and idiopathic hirsutism are the most common causes of the condition. A woman’s history and, physical examination are particularly important in evaluating excess hair growth. The vast majority of women with hirsutism have the idiopathic variety, and the diagnosis is made by exclusion. Serum testosterone level > 200 ng/dL is highly suggestive of adrenal or ovarian tumor. Treatment of hirsutism should be based on the degree of excess hair growth presented by the patient and in the pathophysiology of the disorder. Treatment includes lifestyle therapies, androgen suppression, peripheral androgen blockage, and cosmetic treatments. The current review discusses definition, pathogenesis, physiopathology, differential diagnosis, diagnostic strategies, and treatment.
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Alterations in hair follicle dynamics in women. BIOMED RESEARCH INTERNATIONAL 2013; 2013:957432. [PMID: 24455742 PMCID: PMC3884776 DOI: 10.1155/2013/957432] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 12/14/2013] [Indexed: 12/26/2022]
Abstract
Endocrine changes supervening after parturition and menopause participate in the control of sebum production and hair growth modulation. The ensuing conditions include some peculiar aspects of hair loss (effluvium), alopecia, and facial hirsutism. The hair cycling is of major clinical relevance because most hair growth disorders result from disturbances in this chronobiological feature. Of note, any correlation between a biologic abnormality and hair cycling disturbance does not prove a relationship of causality. The proportion of postmenopausal women is rising in the overall population. Therefore, the prevalence of these hair follicle disturbances is globally on the rise. Current therapies aim at correcting the underlying hormonal imbalances, and at improving the overall cosmetic appearance. However, in absence of pathogenic diagnosis and causality criteria, chances are low that a treatment given by the whims of fate will adequately control hair effluvium. The risk and frequency of therapeutic inertia are further increased. When the hair loss is not controlled and/or compensated by growth of new hairs, several clinical aspects of alopecia inexorably develop. Currently, there is little evidence supporting any specific treatment for these endocrine hair disorders in post-partum and postmenopausal women. Current hair treatment strategies are symptomatic and nonspecific so current researchers aim at developing new, targeted methods.
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Castelo-Soccio LA. Hair manifestations of systemic disease. Curr Probl Pediatr Adolesc Health Care 2012; 42:198-203. [PMID: 22884026 DOI: 10.1016/j.cppeds.2012.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 02/27/2012] [Indexed: 01/19/2023]
Affiliation(s)
- Leslie A Castelo-Soccio
- Section of Dermatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Androgenproduzierende Tumoren. GYNAKOLOGISCHE ENDOKRINOLOGIE 2011. [DOI: 10.1007/s10304-010-0401-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
Hirsutism is an excessive body and facial hair growth in women in locations where is normally minimal or absent following a hair-male pattern. For this reason is not uncommon that hirsutism raises psychological, cosmetic and social concerns. There are many treatment modalities that can be summarised into two broad groups: pharmacologic and non-pharmacologic treatment. Until now, medical treatment has been designed to interfere with the synthesis of androgen at the ovarian or adrenal level, or inhibit the effect of androgen at the receptor level, although recent progresses test other options such as insulin modulators or ornithine decarboxylase inhibitors. Mechanical treatment includes laser hair removal, electrolysis, depilatory creams, plucking and waxing. This article presents a general overview of hirsutism treatment options.
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Affiliation(s)
- Camil Castelo-Branco
- Obstetrics, Gynaecology and Neonatology Clinic Institute, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain.
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Bhatia A, Singh B, Amarji B, Katare OP. Tamoxifen-loaded liposomal topical formulation arrests hair growth in mice. Br J Dermatol 2010; 163:412-5. [PMID: 20331445 DOI: 10.1111/j.1365-2133.2010.09772.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND For several decades, androgens have dominated endocrine research in the domain of hair growth control. However, it has long been known that oestrogens also tend to alter hair follicle (HF) growth and cycling significantly by binding to locally expressed high-affinity oestrogen receptors (ORs). Tamoxifen (TAM) is a selective OR modulator. OBJECTIVES The current work aims to investigate the effect of topically applied TAM on the hair growth of mice. METHODS Test formulations were applied once daily on the shaved back area of the mice for a period of 5 weeks. The effect of these formulations was studied by visual and histological examinations. RESULTS Animals treated with saline and placebo gel formulation showed significant hair growth on the 20th day. The number and length of follicles were also found to be normal. In contrast, no hair growth was observed in the animals treated with TAM gel, even after the termination of treatment. The HFs were found to be arrested in telogen phase with clear signs of follicle dystrophy. CONCLUSIONS The hair growth-retarding effect of TAM observed in the current study clearly demonstrates its OR agonistic effect on hair growth. This work also provides a distinct lead towards the possible potential of TAM liposomal gel in the treatment of hirsutism.
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Affiliation(s)
- A Bhatia
- University Institute of Pharmaceutical Sciences, UGC Centre of Advanced Study, Panjab University, Chandigarh, India
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Jedel E, Waern M, Gustafson D, Landén M, Eriksson E, Holm G, Nilsson L, Lind AK, Janson PO, Stener-Victorin E. Anxiety and depression symptoms in women with polycystic ovary syndrome compared with controls matched for body mass index. Hum Reprod 2009; 25:450-6. [PMID: 19933236 DOI: 10.1093/humrep/dep384] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Anxiety and depression are more prevalent in women with polycystic ovary syndrome (PCOS) than in those without this disorder. Possible confounding effects of overweight and obesity are suggested. The aim was to compare symptoms of anxiety and depression in women with PCOS and controls matched for age, body weight and body mass index (BMI). METHODS Women with PCOS (n = 30) and controls (n = 30) were recruited from the community. Persons with ongoing psychotropic medication were excluded. All potential participants underwent gynecological examination to confirm case-control status. Participants completed the self-reported versions of the Brief Scale for Anxiety (BSA-S) and Montgomery Asberg Depression Rating Scale (MADRS-S). RESULTS Women with PCOS had a higher BSA-S score compared with controls (median, range: 10.5, 1-24 versus 5.0, 0-28, P < 0.001). They scored higher on the following four individual symptoms: reduced sleep (2.0, 0-5 versus 0, 0-2, P < 0.001), worry (1.5, 0-4 versus 0, 0-6, P = 0.004), phobias (1, 0-4 versus 0, 0-3, P < 0.001), and pain (1, 0-3 versus 0, 0-2, P < 0.001). No statistical difference was demonstrated regarding MADRS-S scores (10.0, 0-27 versus 5.5, 0-24, P = 0.053). Only one of the nine MADRS-S symptoms, reduced sleep, which is also included in the BSA-S, differed between cases and controls. CONCLUSIONS Several anxiety symptoms distinguished women with PCOS from a control group matched on BMI. A better understanding of the symptoms is needed to identify and alleviate anxiety symptoms in this vulnerable group.
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Affiliation(s)
- E Jedel
- Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
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Abstract
The hair and nails are rapidly growing structures and as such their cell division can be interrupted by disease states and iatrogenic treatments. Other internal diseases can alter the structure and color of the hair and nails. These alterations in the hair and nails supply important information to the physician regarding the underlying diagnosis.
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Affiliation(s)
- Shannon Harrison
- Department of Dermatology, Cleveland Clinic Foundation, 9500 Euclid Avenue/A61, Cleveland, OH 44195, USA
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Abstract
Hirsutism is a distressing and relatively common problem, affecting 5 to 10% of women in the reproductive age group. It is usually a sign of androgen excess, the commonest cause being the polycystic ovarian syndrome (PCOS). Diagnosis depends mainly on assessment of the clinical symptoms and laboratory values of various hormones. Antiandrogens combined with various cosmetic therapies form the mainstay of treatment.
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Affiliation(s)
- Duru Shah
- Gynaecworld Assisted Fertility Unit, Mumbai, India.
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De Orsi D, Pellegrini M, Pichini S, Mattioli D, Marchei E, Gagliardi L. High-performance liquid chromatography–diode array and electrospray-mass spectrometry analysis of non-allowed substances in cosmetic products for preventing hair loss and other hormone-dependent skin diseases. J Pharm Biomed Anal 2008; 48:641-8. [DOI: 10.1016/j.jpba.2008.06.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2008] [Revised: 06/11/2008] [Accepted: 06/17/2008] [Indexed: 11/16/2022]
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