Wednesday, November 7, 2012


Hirsutism is defined as excessive growth of thick yarn hair, dark women in areas where it is minimal or absent. This model of developing male terminal hair usually occurs in androgen stimulated areas such as the face, chest and mammary areola.Although the terms hirsutism and hypertrichosis are used together, hypertrichosis refers to excessive hair, terminal or velus in areas that are not predominantly androgen dependent.In most cases, hirsutism is a benign condition and mostly cosmetic problem. But when it is accompanied by signs or symptoms of masculinization, when occurs after puberty, may be a manifestation of a severe ailments background as ovarian or adrenal neoplasm.
Most patients with significant hirsutism have PCOS. Treatment of hirsutism itself is only required if you are troubled by physical appearance. The practice of temporary and permanent hair removal. Pharmacological therapies for hirsutism are selected according to underlying disease. Androgens administered continuously. If this manifestation virilizing adrenal tumors are responsible or indicate ovarian tumor removal. Oral contraceptives are often the first step of treatment. Antihypertensives have effects that improve hirsutism, along with corticosteroids, oral antidiabetics.
Pathogenesis of hirsutismHirsutism can be caused by abnormally high levels of androgens or if the hair follicles are more sensitive to normal levels of androgens. Therefore the condition is frequently seen in patients with endocrine disorders characterized by hyperandrogenism, which may be caused by abnormalities of the ovaries or adrenalelor.
Presumed physiological mechanisms underlying androgenic activity include:-Production of androgens by the ovaries or adrenalAndrogens in the blood-transport by transport proteins, SHBG-Modification and intracellular binding to androgen receptor.Central overproduction of androgens, increased peripheral conversion of androgens, decreased metabolism and increased binding to each receptor are potential causes for hirsutism. Because circulating testosterone exert their stimulatory effects on hair must be converted to a metabolite dihydrotestosterone. 5-alpha-reductase enzyme found in the hair follicle realize this transformation.
Overproduction of androgens increases follicle size, increased hair diameter and length of the anagen phase. In addition to the hair quality and volume change more results and increased secretion of sebum. Hair distribution in women with androgen raised is changed. Hair appears in excess in androgen sensitive areas and scalp alopecia. Severity of hirsutism does not correlate directly with the level of circulating androgens due to individual differences in sensitivity conversion to dihydrotestosterone and hair follicles. Estrogens act in opposition, slowing growth and production of fine and long hairs. Progesterone has minimal effects on hair.
Causes and risk factors for hirsutismOvarian causes of hirsutism.Polycystic ovary syndrome is a condition affecting androgen levels. It is chic most common cause of hirsutism and androgen excess. Virilization is minimal but hirsutism is prominent. Characteristics include menstrual irregularities, dysmenorrhea, intolerenta glucose and hyperinsulinemia and obesity. Hyperinsulinemia stimulates the ovaries to produce androgens. Women with polycystic policistice may be another characteristic element of androgenismului-recalcitrant acne, acanthosis nigricans, alopecia scalp.
Other conditions that cause hirsutism include ovarian:-Luteomul of pregnancy, arenoblastoameleLeyding-cell tumors, hilar cell tumors-Theca cell tumors.
Hirsutism family.It is not associated with androgen excess. Is typical and natural in certain populations such as women Mediterranean and Middle Eastern ancestry.
Drug-induced hirsutism.Drugs can induce hirsutism by Androgenic effects: dehidroepiandrosetrn sulfate, testosterone, danazol, anabolic steroids. Drugs such as phenytoin, minoxidil, diazoxide, cyclosporine, streptomycin, psoralen, penicillamine, high dose corticosteroids, phenothiazines, acetazolamide, Hexachlorobenzene exerts independent effects of androgens. Madicamente induced hirsutism hypertrichosis is different in that appear fine threads seem large areas of the trunk, hands and face androgen independent.
Adrenal causes of hirsutism.Congenital adrenal hyperplasia can cause hirsutism. These children are born with ambiguous genitalia, symptoms of salt loss, and lack of seat. May develop male characteristics. Signs of virilization and menstrual irregularities are observed only at puberty. Cushing's syndrome is a form of adrenal hyperplasia nongenitala characterized by adrenal cortisol excess. The most notable appearance of excess velus.
Other causes of hirsutism include:-Acromegaly, hypothyroidism-Hyperprolactinemia, porphyria-Idiopathic hirsutism.

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