Clinical Evaluation and Therapeutic Outcome in Hirsutism

Subha, R (2012) Clinical Evaluation and Therapeutic Outcome in Hirsutism. Masters thesis, Madras Medical College, Chennai.


Download (9MB) | Preview


INTRODUCTION : Hirsutism is defined as the presence of terminal coarse hairs in women in a male like distribution. Hirsutism affects approximately 5 to 10% of women of reproductive age. Androgen dependent areas include the chin, upper lip, chest, abdomen, back and anterior thighs. Hirsutism usually represents a variation of normal hair growth, but rarely it is a harbinger of a serious underlying condition. It may be a complaint for which the patient seeks medical advice or may be only a suspicion by a dermatologist seeing a woman for other androgen related problems like female pattern hair loss. Studies of the psychological burden of hirsutism suggest that it has a significant impact and adversely affects quality of life. Virilisation refers to a condition in which androgen levels are sufficiently high to cause additional signs and symptoms such as deepening of voice, breast atrophy, increased muscle bulk, clitoromegaly and increased libido. Virilisation is an ominous sign that suggests the possibility of an ovarian or adrenal neoplasm. Genetic factors and ethnic background also influence hair growth. In general, dark haired individuals tend to be more hirsute than fair individuals. AIMS OF THE STUDY 1. To know the prevalence of hirsutism among different age groups. 2. To identify the associated factors like acne, acanthosis nigricans, diabetes mellitus, hypertension and obesity. 3. To study the etiology of hirsutism. 4. To study the efficacy of Nd YAG laser & IPL in selected hirsutism patients. 5. To study the incidence of side effects following Nd YAG laser & IPL. MATERIALS AND METHODS : Study design : Prospective descriptive study. Study centre : Department of Dermatology, Rajiv Gandhi Government Hospital, Chennai Study period : October 2009 to September 2011. Sample size : Seventy three patients. Inclusion criteria : All hirsutism patients with Ferriman Gallway score of 8 or more. Exclusion criteria : Patients with Ferriman Gallway score of <8. Clinical evaluation : Complete history, general examination and dermatological examination were done for all patients included in the study by using a proforma. Investigations including postprandial blood glucose, lipid profile, USG abdomen & pelvis, hormonal assay - LH, FSH, testosterone, thyroid function test & prolactin were done for all patients. DHEAS & 17 hydroxy progesterone were done for indicated cases. With the investigation results, endocrine opinion was obtained for all patients. Polycystic ovarian disease was diagnosed based on Rotterdam Consesus Criteria. CONCLUSIONS : 1. Hirsutism is commonly seen in the age group of 14 to 48 years. Adolescent patients appear to be more concerned about hirsutism as compared to those in the older age group. 2. Acanthosis nigricans (31.5%) was the most common cutaneous finding in our study. Acne was associated in 17.8% patients. Androgenetic alopecia was found in 15% of cases. 3. Infertility was seen in 12.2% case. Diabetes mellitus with hypertension was seen in 9.6% patients and obesity in 28% of patients. 4. Idiopathic hirsutism (53%) was the most common cause in our study. PCOS (31.5%) was the second common cause. Family history was present in 22% cases. 5. Due to PCOS, hypothyroidism and Cushing’s syndrome, 48% of patients had menstrual irregularities. 6. Most of the patients (73%) had Ferri Gallwey score in the range of 8 to 16. All patients, however, were more concerned about facial hair than those on other body areas. 70 7. In Q switched Nd YAG, most of the patients had good response after the 5th sitting. In IPL, majority had good response after the 4th sitting. 8. Good response was seen in 70% of the patients in both NdYAG and IPL groups. Excellent response was seen in 20% of Nd YAG group and 15% of IPL group. There is no difference in hair removal efficacy between PCOS and non PCOS patients. 9. In Q switched Nd YAG and IPL hair removal, there was no difference in efficacy in different skin types. 10. Transient erythema, edema and crusting were the complications observed in Q switched Nd YAG laser hair reduction. No side effects with IPL laser were noted in our study.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Hirsutism ; Clinical Evaluation ; Therapeutic Outcome.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 01 Mar 2018 17:24
Last Modified: 03 Mar 2018 07:57

Actions (login required)

View Item View Item