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Hypertrichosis

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161. Anabolic steroid use disorder

effects of steroids increased weight gain and muscular build increased appetite aggression and mood swings hirsutism voice pitch alterations clitoral hypertrophy disproportionate muscular development of upper torso testicular atrophy acne and/or oily skin temporal hairline recession/male pattern baldness striae or keloids menstrual irregularities changes in libido scrotal pain impotence infertility premature masculinisation/feminisation (adolescents) cognitive impairment GI upset short stature

2018 BMJ Best Practice

162. Overview of substance use disorders and overdose

in libido. The potential irreversible masculinising effects include hirsutism, male pattern baldness, deepening of the voice, and clitoral hypertrophy. Occurs by acute single ingestion of a large amount or by repeated ingestion of an amount exceeding the recommended dosage or by multiple doses. Poisoning may cause various degrees of liver injury including fulminant hepatic failure and hepatorenal syndrome. Patients are often asymptomatic or have only mild gastrointestinal symptoms at initial

2018 BMJ Best Practice

163. Infertility in women

presence of risk factors hx of prior pelvic surgery irregular menstrual cycles hirsutism acne palpable uterine abnormalities adnexal abnormalities galactorrhoea dyspareunia cul de sac abnormalities age >35 years hx of sexually transmitted disease very high body fat very low body fat cigarette smoking auto-immune disease hx of appendicitis psychiatric disease substance abuse alcohol consumption caffeine consumption stress Diagnostic investigations semen analysis luteal-phase progesterone urinary

2018 BMJ Best Practice

164. Polycystic ovary syndrome

://jcem.endojournals.org/cgi/content/full/91/11/4237 http://www.ncbi.nlm.nih.gov/pubmed/16940456?tool=bestpractice.com Azziz R, Carmina E, Dewailly D, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. 2009 Feb;91(2):456-88. http://www.ncbi.nlm.nih.gov/pubmed/18950759?tool=bestpractice.com History and exam presence of risk factors female of reproductive age irregular menstruation infertility hirsutism acne overweight or obesity

2018 BMJ Best Practice

165. Porphyria cutanea tarda

Porphyria cutanea tarda Porphyria cutanea tarda - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Porphyria cutanea tarda Last reviewed: February 2019 Last updated: March 2018 Summary Presents with blistering and crusted skin lesions on the back of hands and other sun-exposed areas of the body. Other common features include skin fragility, with minor trauma causing blister formation, hypertrichosis, skin (...) (Chapter 58). In: Kaushansky K, Lichtman MA, Beutler E, et al, eds. Williams Hematology, 9th ed. New York, NY: McGraw-Hill;2016: 889-914. PCT is usually associated with liver cell damage. History and exam presence of risk factors blistering skin lesions skin hyperpigmentation hypertrichosis scarring alopecia red urine males, middle age, white alcohol use smoking oestrogen use hepatitis C HIV hereditary haemochromatosis gene (HFE) mutation uroporphyrinogen decarboxylase (UROD) mutations exposure

2018 BMJ Best Practice

166. Metabolic syndrome

its individual components regarding cardiovascular risk is greatly controversial. History and exam presence of risk factors hypertension increased BMI increased waist and hip circumferences type 2 DM non-alcoholic fatty liver disease angina claudication sleep disturbance, excessive daytime sleepiness, snoring, gasping breaths hyperuricaemia menstrual disturbances abdominal pain corneal arcus and xanthelasma hirsutism acanthosis nigricans acne hepatomegaly obesity insulin resistance physical

2018 BMJ Best Practice

167. Cushing's syndrome

or diabetes mellitus premature osteoporosis or unexplained fractures weight gain and central obesity acne psychiatric symptoms decreased libido easy bruisability weakness facial rounding dorsocervical fat pads unexplained nephrolithiasis hirsutism exogenous corticosteroid use pituitary adenoma adrenal adenoma adrenal carcinoma neuroendocrine tumours thoracic or bronchogenic carcinoma Diagnostic investigations urine pregnancy test serum glucose late-night salivary cortisol 1 mg overnight dexamethasone

2018 BMJ Best Practice

168. Overview of substance use disorders and overdose

in libido. The potential irreversible masculinising effects include hirsutism, male pattern baldness, deepening of the voice, and clitoral hypertrophy. Occurs by acute single ingestion of a large amount or by repeated ingestion of an amount exceeding the recommended dosage or by multiple doses. Poisoning may cause various degrees of liver injury including fulminant hepatic failure and hepatorenal syndrome. Patients are often asymptomatic or have only mild gastrointestinal symptoms at initial

2018 BMJ Best Practice

169. Cushing syndrome

or diabetes mellitus premature osteoporosis or unexplained fractures weight gain and central obesity acne psychiatric symptoms decreased libido easy bruisability weakness facial rounding dorsocervical fat pads unexplained nephrolithiasis hirsutism exogenous corticosteroid use pituitary adenoma adrenal adenoma adrenal carcinoma neuroendocrine tumours thoracic or bronchogenic carcinoma Diagnostic investigations urine pregnancy test serum glucose late-night salivary cortisol 1 mg overnight dexamethasone

2018 BMJ Best Practice

170. Update on the management of hirsutism. Full Text available with Trip Pro

Update on the management of hirsutism. Hirsutism is a source of significant anxiety in women. While polycystic ovary syndrome or other endocrine conditions are responsible for excess androgen in many patients, other patients have normal menses and normal androgen levels ("idiopathic" hirsutism). The goal of the evaluation is to rule out any underlying pathology. The goals of therapy are to treat any underlying condition and to remove the excess hair. Current options for hair removal

2010 Cleveland Clinic Journal of Medicine

171. Hirsutism scoring in polycystic ovary syndrome: concordance between clinicians' and patients' self-scoring. (Abstract)

Hirsutism scoring in polycystic ovary syndrome: concordance between clinicians' and patients' self-scoring. In a clinical series of 68 women with polycystic ovary syndrome in which the reason for consultation was hirsutism, the mean (standard error of the mean) hirsutism score of the modified Ferriman-Gallwey method was 15.1 (6.8), compared with 12.0 (4.4) for clinicians' scoring. In the multivariable analysis, clinicians' scoring of hirsutism was the only independent variable significantly

2010 Fertility and Sterility

172. Total testosterone assays in women with polycystic ovary syndrome: precision and correlation with hirsutism. Full Text available with Trip Pro

Total testosterone assays in women with polycystic ovary syndrome: precision and correlation with hirsutism. There is no standardized assay of testosterone in women. Liquid chromatography mass spectrometry (LC/MS) has been proposed as the preferable assay by an Endocrine Society Position Statement.The aim was to compare assay results from a direct RIA with two LC/MS.We conducted a blinded laboratory study including masked duplicate samples at three laboratories--two academic (University (...) of Virginia, RIA; and Mayo Clinic, LC/MS) and one commercial (Quest, LC/MS).Baseline testosterone levels from 596 women with PCOS who participated in a large, multicenter, randomized controlled infertility trial performed at academic health centers in the United States were run by varying assays, and results were compared.We measured assay precision and correlation and baseline Ferriman-Gallwey hirsutism scores.Median testosterone levels were highest with RIA. The correlations between the blinded samples

2010 The Journal of clinical endocrinology and metabolism Controlled trial quality: predicted high

173. Hair removal in hirsute women with normal testosterone levels: a randomized controlled trial of long-pulsed diode laser vs. intense pulsed light. (Abstract)

Hair removal in hirsute women with normal testosterone levels: a randomized controlled trial of long-pulsed diode laser vs. intense pulsed light. Hirsutism is a common disorder in women of reproductive age, and androgen disturbances may aggravate the condition. Limited evidence exists regarding efficacy of hair removal in this specific population and no data are available for patients with verified normal testosterone levels.To compare efficacy and safety of intense pulsed light (IPL) vs. long (...) -pulsed diode laser (LPDL) in a well-defined group of hirsute women with normal testosterone levels.Thirty-one hirsute women received six allocated split-face treatments with IPL (525-1200 nm; Palomar Starlux IPL system) and LPDL (810 nm; Asclepion MeDioStar XT diode laser). Testosterone levels were measured three times during the study period. Patients with intrinsically normal or medically normalized testosterone levels throughout the study were included in efficacy assessments (n = 23). Endpoints

2010 The British journal of dermatology Controlled trial quality: uncertain

174. Bariatric surgery: an HTA report on the efficacy, safety and cost-effectiveness

SGastro oesophagal reflux Urinary incontinence Osteoarthritis Varicose veins Increased peripheral steroid interconversion in adipose tissue Hormone-dependent cancers (breast, uterus) Male hypogonadism Influence on polycystic ovarian syndrome or PCOS (infertility, hirsutism) Others Psychological morbidity / psychosocial impact (low self-esteem, body image disorder, depression, social isolation and stigmatisation) Socioeconomic disadvantage (lower income, un-employment, less likely to be promoted

2019 Belgian Health Care Knowledge Centre

175. Translation and implementation of the Australian-led PCOS guideline: clinical summary and translation resources from the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

testosterone levels. Other forms of hormonal contraception are less effective in this regard. COCP use for 6–12 months reduces androgens and hirsutism. Mood impacts have not been shown in PCOS; however, general population studies have noted COCP impact on libido and mood. No one preparation has been shown to be superior in PCOS, with all COCP agents increasing sex hormone-binding globulin and improving clinical outcomes. Based on general population data, COCPs are recommended at the lowest effective (...) modification, and is recommended in addition to lifestyle intervention, not as a substitute. Low dose therapy is recommended initially, with subsequent titration to reduce the mild and self-limiting gastrointestinal side effects. Anti-androgens in PCOS have limited evidence and are only recommended for hirsutism when at least 6 months of COCPs with cosmetic therapy have failed. Bariatric surgery can improve clinical features; however, registry studies demonstrate concerns around pregnancy outcomes

2018 MJA Clinical Guidelines

176. Cetirizine

, Finasteride, Serenoa repens) and show some side effects. In literature, on the basis of hypertrichosis observed in patients treated with analogues (...) of prostaglandin PGF2α, was supposed that prostaglandins would have an important role in the hair growth: PGE and PGF2α play a positive role, while PGD2 a negative one. We carried out a pilot study to evaluate the efficacy of topical cetirizine versus placebo in patients with androgenetic alopecia. We found that the main effect of cetirizine

2018 Trip Latest and Greatest

177. International evidence-based guideline for the assessment and management of polycystic ovary syndrome (PCOS)

(irregular menstrual cycles, hirsutism, infertility and pregnancy complications) [9] and metabolic features (insulin resistance (IR), metabolic syndrome, prediabetes, type 2 diabetes (DM2) and cardiovascular risk factors) [10, 11]. Diagnosis and treatment of PCOS remain controversial with challenges defining individual components within the diagnostic criteria, significant clinical heterogeneity generating a range of phenotypes with or without obesity, ethnic differences and variation in clinical (...) in establishing the diagnosis of PCOS and/or phenotype where clinical signs of hyperandrogenism (in particular hirsutism) are unclear or absent. 1.2.8 CPP Interpretation of androgen levels needs to be guided by the reference ranges of the laboratory used, acknowledging that ranges for different methods and laboratories vary widely. Normal values are ideally based on levels from a well phenotyped healthy control population or by cluster analysis of a large general population considering age and pubertal

2018 European Society of Human Reproduction and Embryology

178. Screening and Management of the Hyperandrogenic Adolescent

symptoms are hirsutism and acne. Reports of hirsutism and acne should be taken seriously because of their possible association with medical disorders, their substantial effect on self-esteem and quality of life, and the potential for psychosocial morbidity. In patients with symptoms of androgen excess, the differential diagnosis should include physiologic hyperandrogenism of puberty, idiopathic hyperandrogenism, and polycystic ovary syndrome (PCOS). There is a great deal of overlap between the symptoms (...) of PCOS and those of normal puberty,whichmakesthediagnosisofPCOSintheadolescentdifficult.Treatmentofacneandhirsutismshould not be withheld during the ongoing longitudinal evaluation for possible PCOS. On physical examination, body mass index, blood pressure, and signs of hyperandrogenism, such as acne and hirsutism, should be evaluated. Although guidelines differ on recommended laboratory studies, most include measurement of total testoster- one, free testosterone, or both, and screening

2019 American College of Obstetricians and Gynecologists

180. Testosterone replacement in menopause

as appropriate female physiological doses are prescribed adverse androgenic effects are not problematic and virilising problems do not occur. Reported adverse effects are shown below; if thought to be linked, the dosage should be reduced or treatment stopped. • Increased body hair at site of application (occasional problem) – spread more thinly, vary site of application, reduce dosage. • Generalised Hirsutism (uncommon) • Alopecia, male pattern hair loss (uncommon) • Acne and greasy skin (uncommon

2019 British Menopause Society

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