Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:13

High-Oxygen-Affinity Hemoglobins Hirsutism (Dermatology) 711

follow-up

n/a

complications and prognosis

n/a

HIRSUTISM (DERMATOLOGY)

LEE CARSON, MD and MICHAEL J. WHITE, MD

history & physical

History

■Normally a complaint of female patients, except for medication

effects (below)

■Previous Diagnoses: Cushing’s, acromegaly or other endocrine dis-

orders

■Medications: Androgens, cyclosporine, dizoxide, glucocorticoids,

and minoxidil

■Racial predilection: Middle Eastern, Russian, and Southern Euro-

pean countries

■Related history: Family history of hirsutism, menstrual irregulari-

ties, infertility, diabetes, rate of progression of clinical hirsutism

Signs & Symptoms

■Hirsutism:

➣Subjective judgment that excess hair exists. Hair may be in

unwanted places or terminal hair replacing vellus hair.

➣Excess of terminal hair growth involving the upper lip, cheeks,

chin, central chest, breasts, lower abdomen, or groin

■Other related findings:Temporal/androgenic balding, masculine

body habitus, acne, obesity, acanthosis nigricans, galactorrhea,

deepening of voice, and clitoral hypertrophy; in general “masculin-

ization” features

tests

Laboratory

■If problem is mild, gradual onset, with regular menses – none

■Moderate to more severe, with other signs and symptoms: serum

testosterone+DHEAS

■Suspected polycystic ovarian syndrome (PCOS): fasting blood sugar