16 - 90 - HIRSUTISM AND HYPERTRICHOSIS Flashcards
defined as terminal body hair growth in women in a male distribution
Hirsutism
what score of Ferriman-Gallwey is considered hirsute?
8 or higher
excess hair has a more generalized distribution and independent of androgens
hypertrichosis
most potent androgen
dihydrotestosterone (DHT)
DHT is produced from the peripheral enzymatic conversion of testosterone by 5α-reductase
cutaneous signs of hyperandrogenism
hirsutism, acne, acanthosis nigricans, androgenetic alopecia, seborrheic dermatitis, and signs of virilization
Signs of virilization include clitoromegaly, male pattern balding, deepening voice, or decreased breast size
most commonly involved areas in hirsutism
**upper lip **> thighs > lower abdomen > upper back
this scale is a systematic assessment tool for the degree of hirsutism of nine body locations, which when combined, allow for an overall diagnosis of hirsutism
modified Ferriman and Gallwey (mFG) scoring
- It assigns a score of 1 to 4 in nine body areas, with an increasing numeric score corresponding to greater hair density
- The score varies from 0 (no hair) to 4 (extensive hair growth) in each area
Normal hair growth is defined by a modified Ferriman and Gallwey (mFG) score of?
8 or less
what is the modified Ferriman and Gallwey (mFG) score of mild hirsutism
8 - 14
modified Ferriman and Gallwey (mFG) score of greater than 15 indicates what severity of hirsutism?
moderate to severe hirsutism
most common associated cause of hyperandrogenism in women of reproductive age and is a common secondary cause of hirsutism
Polycystic ovarian syndrome, also known as SteinLeventhal syndrome
SAHA syndrome
seborrhea, acne, hirsutism, and androgenetic alopecia
HAIR-AN
hyperandrogenism (HA), insulin resistance (IR), and acanthosis nigricans (AN)
biochemical hallmark of Adrenal hyperplasia
elevated 17-hydroxyprogesterone (17-OHP), substrate of 21-hydroxylase
the only one prescription medication that is approved for the treatment of unwanted facial hair
topical eflornithine
- shown to slow down the hair growth cycle and can be used in combination with other hair removal techniques.
- Eflornithine works through inhibiting ornithine decarboxylase, which results in a shortening of the anagen phase of the hair growth cycle.
- The major adverse effects of topical eflornithine are burning or tingling of the treated area.
First-line medical therapy of hirsutism
oral contraceptives (OCPs)
usually in combination with antiandrogens, such as spironolactone and flutamide
the only hair removal methods that may provide permanent hair reduction or long-lasting results
Electrolysis and laser hair reduction
- Electrolysis uses a fine needle insertion into individual follicles to destroy the hair follicle via current (galvanic electrolysis), a high-frequency alternating current (thermolysis), or a blend of the two
- Electrolysis is the favored method of treatment for lightly pigmented hair because only anagen hair follicles with dark bulb areas can be destroyed by the light source of laser.
defined as hair growth that is excessive in a localized or diffuse pattern not considered to be in a male pattern distribution
Hypertrichosis
rare, inherited disorder in which an excess of lanugo hair remains over the entire body after birth or may develop in the first few months of life.
Congenital hypertrichosis lanuginosa, at times controversially referred to as Ambras syndrome
- Only the palms, soles, mucous membranes, and glans penis are spared.
- Some of these patients lose the hair during childhood, but others retain the excess body hair.
similar to CHL in presentation but with terminal hair growth on the body instead of lanugo hair.
Congenital generalized hypertrichosis
autosomal dominant disorder characterized by newborns with thick scalp hair and excessive hair growth on the forehead, face, back, and extremities
Osteochondrodysplasia with hypertrichosis (Cantú syndrome)
- The hypertrichosis usually persists over time. Associated findings include skeletal abnormalities and a variety of cardiac abnormalities.
- The diagnosis is established based on clinical findings and confirmed by detection of a heterozygous pathogenic variant in ABCC9 or KCNJ8.
genetic syndrome characterized by severe overgrowth of the hair and gums
Gingival fibromatosis with hypertrichosis
most commonly reported syndromes in which hypertrichosis is a secondary characteristic
Cornelia de Lange syndrome, also known as Brachmann-de Lange syndrome
- t is characterized by severe mental retardation, cutis marmorata, frequent limb abnormalities, and characteristic facial features (micrognathia, high palate, low frontal hair line) with the hypertrichosis most prominent as thickened convergent (synophrys) eyebrows with hypertrichotic eyelashes
