hirsutism

Question 1

Briefly describe this hirsutism scoring system.

Answer 1

Clinical system to score hirsutism by examining 9 areas of the body

• Thighs
• lower abdomen/mons
• linea alba
• chest
• upper back
• lower back
• Forearms
• Chin
• Upper lip

Each area is given a score of 0 (no hair ) to 4 (frankly virile) and added

• <8 normal
• 8-15 mild
• >15 mod to severe hirsutism.

Hirsutism: Excessive growth of coarse terminal hairs in androgen-dependent areas. Score > 8 suggest hyperandrognism

Question 2

Name 2 potential problems in the clinical utility of this scoring system

Many women use hair removal products and so extent of hirsutism may not be apparent- underscored

Extent of hirsutism does not necessarily correlate with distress experienced by the women

Describes clinical severity of the hirsituism without any indication as to the cause

Doesn’t take into account differences in different ethnic groups. Expression of hair growth varies between ethnic groups for eg FG score > 2 is abnormal in Asian women

Answer 2

• Many women use hair removal products and so extent of hirsutism may not be apparent- underscored
• Extent of hirsutism does not necessarily correlate with distress experienced by the women
• Describes clinical severity of the hirsituism without any indication as to the cause
• Doesn’t take into account differences in different ethnic groups. Expression of hair growth varies between ethnic groups for eg FG score > 2 is abnormal in Asian women

Question 3

3 possible cause of hirsutism

Answer 3

PCOS

Androgen producing tumour ( either adrenal or ovarian)

Congenital adrenal hyperplasia (21 hydroxylase deficiency)

Ethnicity