Hirsutism

多毛症
  • 文章类型: Journal Article
    Rabson-Mendenhall综合征(RMS)是一种罕见的常染色体,以胰岛素受体(INSR)基因突变导致的严重胰岛素抵抗为特征的隐性疾病。本研究旨在分析RMS的临床特征和基因突变,尚未被广泛研究。
    PubMed,Embase,中国国家知识基础设施,和万方搜索“拉布森-门登霍尔综合征”或“黑棘皮病多毛症胰岛素抵抗综合征”。\"
    共纳入33篇文章中的42例。体重指数为18.50~20.00kg/m2,平均16.00kg/m2。无超重(25.00~29.90kg/m2)或肥胖(≥30.00kg/m2)患者。棘皮病29例(29/42,69.05%);生长迟缓25例(25/42,59.52%);牙齿异常包括缺牙,拥挤,错牙合23例(23/42,54.76%);多毛17例(17/42,40.48%)。糖化血红蛋白平均为9.35%,平均空腹血糖为8.44mmol/L;平均空腹胰岛素为349.96μIU/mL,平均空腹C肽为6.00ng/mL。糖尿病25例(25/33,75.76%)均在23岁以前确诊。所有42例患者都有基因突变记录,其中22例(22/42,52.38%)具有≥2个突变,20例(20/42,47.62%)仅具有1个突变。不同突变患者的临床特征和实验室指标无统计学差异。
    该研究表明,高胰岛素血症的年轻患者应考虑RMS,低体重的高血糖症,黑棘皮病,生长迟缓,牙齿异常,和多毛症。
    UNASSIGNED: Rabson-Mendenhall syndrome (RMS) is a rare autosomal, recessive disorder characterized by severe insulin resistance due to mutations in the insulin receptor (INSR) gene. This study aims to analyze the clinical features and gene mutations in RMS, which have not been extensively studied.
    UNASSIGNED: PubMed, Embase, the China National Knowledge Infrastructure, and Wanfang were searched for \"Rabson-Mendenhall syndrome\" or \"Black acanthosis hirsutism insulin resistance syndrome.\"
    UNASSIGNED: A total of 42 cases from 33 articles were included. The body mass index ranged from 18.50 to 20.00 kg/m2 with an average of 16.00 kg/m2. There were no overweight (25.00∼29.90 kg/m2) or obese (≥30.00 kg/m2) patients. Acanthosis was present in 29 cases (29/42, 69.05%); growth retardation in 25 cases (25/42, 59.52%); dental anomalies including absence of teeth, crowding, and malocclusion in 23 cases (23/42, 54.76%); and hirsutism in 17 cases (17/42, 40.48%). The average glycosylated hemoglobin was 9.35%, and the average fasting blood-glucose was 8.44 mmol/L; the mean fasting insulin was 349.96 μIU/mL, and the average fasting C-peptide was 6.00 ng/mL. Diabetes was reported in 25 cases (25/33, 75.76%) all of which were diagnosed before 23 years old. All 42 patients had recorded gene mutations, with 22 patients (22/42, 52.38%) having ≥ 2 mutations and 20 cases (20/42, 47.62%) having only 1 mutation. No statistical differences were found in clinical features and laboratory parameters between patients with different mutations.
    UNASSIGNED: The study indicates that RMS should be considered in young patients with hyperinsulinemia, hyperglycemia with low weight, acanthosis nigricans, growth retardation, dental anomalies, and hirsutism.
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  • 文章类型: Journal Article
    背景:本研究旨在观察激光辅助脱毛(LAHR)对多囊卵巢综合征(PCOS)相关多毛症女性生活质量的影响。
    方法:在专门诊所对172名患有PCOS的女性进行了观察性研究。采用皮肤病学生活质量指数(DLQI)和Ferriman-Gallwey(FG)评分评估多毛症的生活质量和严重程度,分别。使用红宝石二极管或翠绿宝石激光器进行激光治疗。在12-进行DLQI和FG评分评估的随访,18-,治疗后24周。
    结果:报告压力的病例数,焦虑,随着时间的推移,抑郁症也会减少。然而,患者报告的下降与DLQI评分之间无相关性.FG评分与心理健康显著相关。多毛症的严重程度影响了心理健康。6个月时头发的再生表明LAHR的长期疗效有限。
    结论:LAHR在短期内显著改善了PCOS患者的生活质量。然而,该疗法的短期获益表明需要进行研究以寻找新的治疗策略.
    BACKGROUND: This study aimed to observe the impact of laser-assisted hair removal (LAHR) on the quality of life in women with polycystic ovary syndrome (PCOS)-associated hirsutism.
    METHODS: An observational study was conducted on 172 women living with PCOS at a specialized clinic. The Dermatology Life Quality Index (DLQI) and Ferriman-Gallwey (FG) score were employed to assess the quality of life and severity of hirsutism, respectively. Laser therapy was administered using ruby diode or alexandrite lasers. Follow-up on the DLQI and FG score assessment was done at 12-, 18-, and 24-week post-treatment.
    RESULTS: The number of cases that reported stress, anxiety, and depression reduced over time. However, there was no correlation between the patient-reported decrease and DLQI scores. The FG score was significantly related to mental health. The severity of the hirsutism impacted mental health. The regrowth of hair at six months indicated limited long-term efficacy LAHR.
    CONCLUSIONS:  LAHR significantly improves the quality of life in the short term for women living with PCOS. However, the short-term benefit of the therapy indicates a need for research to find new treatment strategies.
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  • 文章类型: Journal Article
    多毛症是一种可以有医疗的疾病,社会,和心理影响,影响全世界5%到10%的女性。管理选择包括整容手术和药物干预。然而,用于治疗多毛症的药物会有副作用,从恶心和头痛等轻微症状到血管凝块等更严重的并发症,心脏病发作,肝毒性,骨质疏松,和男性胎儿的女性化。因此,这项研究旨在探讨药用植物对多毛症的潜在益处,作为一种补充方法,特别是它们是否可以用作化妆品程序的佐剂。包括谷歌学者在内的数据库,PubMed,Scopus,Embase,ISI,SID,从2000年到2023年,Mag伊朗已经使用相关关键字进行了检查。此外,相关文章被隔离。总的来说,在搜索中确定了10项试验.结果表明,各种草药,包括茴香,甘草,留兰香,看到了棕榈,绿茶,Zingiber和neem的组合,姜黄素,和teupolioside有潜力作为草药治疗多毛症。然而,需要进一步广泛的精心设计的研究,涉及对最有希望的草药的大样本量,以确定其疗效。
    Hirsutism is a condition that can have medical, social, and psychological implications, affecting 5% to 10% of women worldwide. Management options include cosmetic procedures and pharmacological interventions. However, medications used to treat hirsutism can have side effects, ranging from mild symptoms like nausea and headaches to more serious complications such as vascular clots, heart attacks, hepatotoxicity, osteoporosis, and effeminization of a male fetus. Therefore, this study aims to investigate the potential benefits of medicinal plants on hirsutism as a complementary approach, specifically whether they can be used as adjuvants to cosmetic procedures. Databases including Google Scholar, PubMed, Scopus, Embase, ISI, SID, and Mag Iran have been checked with related keywords from 2000 to 2023. Moreover, related articles were isolated. In total, ten trials were identified in the search. The results suggested that various herbs, including fennel, licorice, spearmint, saw palmetto, green tea, combination of Zingiber and neem, curcumin, and teupolioside have the potential as herbal remedies for hirsutism. However, further extensive well-designed studies involving a large sample size on the most promising herbs are necessary to determine their efficacy.
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  • 文章类型: Case Reports
    非经典先天性肾上腺增生(NCAH)是一种遗传性疾病,其特征是编码与皮质醇产生有关的酶的基因突变。最常见的是21-羟化酶。与经典的先天性肾上腺增生(CAH)不同,NCAH通常在以后的生活中出现较轻的症状。NCAH的诊断可能由于其非特异性症状和可变表现而具有挑战性。及早发现对于及时干预和管理至关重要,特别是在有病史的家庭中。我们报告了一名来自突尼斯中东部地区的NCAH患者,随后的基因检测显示CYP21A2基因中的Val281Leu(V281L)突变。一名26岁的女性出现面部多毛症和月经周期不规则。体格检查显示轻度多毛症,实验室检查显示睾丸激素和17-羟基孕酮(17-OHP)水平升高。对NCAH进行了临时诊断,随后通过促肾上腺皮质激素(ACTH)刺激试验证实,显示17-OHP反应过度。遗传检测揭示了V281L突变的杂合性。家庭测试显示患者的母亲是纯合的,父亲是杂合的。该报告强调了识别NCAH的细微症状对早期诊断和治疗的重要性。基因检测有助于确认诊断和识别家庭内的携带者。糖皮质激素治疗旨在抑制肾上腺雄激素产生并控制症状。定期随访对于监测治疗反应和根据需要调整药物至关重要。NCAH可以表现出微妙的症状,需要高度怀疑才能正确诊断。基因检测在确认诊断和识别家庭中的携带者中起着至关重要的作用。早期干预和定期随访可改善受影响个体的预后。该报告还强调了基因检测在NCAH管理中的重要性,并强调需要提高医疗保健提供者对这种情况的认识。
    Nonclassic congenital adrenal hyperplasia (NCAH) is a genetic disorder characterized by mutations in the genes encoding enzymes involved in cortisol production, most commonly the 21-hydroxylase enzyme. Unlike classic congenital adrenal hyperplasia (CAH), NCAH typically presents later in life with milder symptoms. The diagnosis of NCAH can be challenging due to its nonspecific symptoms and variable presentation. Early detection is crucial for timely intervention and management, particularly in families with a history of the condition. We report a case of NCAH in a patient from the Central-East Region of Tunisia, in whom the subsequent genetic testing revealed a Val281Leu (V281L) mutation in the CYP21A2 gene. A 26-year-old female presented with facial hirsutism and irregular menstrual cycles. Physical examination revealed mild hirsutism and laboratory tests showed elevated levels of testosterone and 17-hydroxyprogesterone (17-OHP). A provisional diagnosis of NCAH was made, subsequently confirmed by an adrenocorticotropic hormone (ACTH) stimulation test demonstrating an exaggerated 17-OHP response. Genetic testing revealed heterozygosity for the V281L mutation. Family testing showed the patient\'s mother to be homozygous and the father heterozygous for the mutation. This report highlights the importance of recognizing subtle symptoms of NCAH for early diagnosis and management. Genetic testing aids in confirming the diagnosis and identifying carriers within families. Treatment with glucocorticoids aims to suppress adrenal androgen production and manage symptoms. Regular follow-up is essential to monitor treatment response and adjust medication as needed. NCAH can present with subtle symptoms, necessitating a high index of suspicion for a proper diagnosis. Genetic testing plays a crucial role in confirming the diagnosis and identifying carriers within families. Early intervention and regular follow-up improve outcomes in affected individuals. This report also underscores the significance of genetic testing in the management of NCAH and highlights the need for increased awareness about this condition among healthcare providers.
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  • 文章类型: Journal Article
    背景:多囊卵巢综合征(PCOS)是育龄期妇女普遍存在的内分泌代谢紊乱。诊断基于2018年循证国际指南和鹿特丹共识对PCOS表型进行分类。本研究旨在表征生物人口统计学,临床,新陈代谢,厄瓜多尔安第斯山脉人群的生殖变量及其与PCOS表型的关系。方法:采用非随机连续抽样的92名妇女进行了横断面研究,这些妇女在Loja技术大学(UTPL)-SantaInés医院门诊妇科和内分泌科诊所就诊,Loja,厄瓜多尔,2022年1月至2023年7月。描述性统计,均值计算,标准偏差,参数和非参数测试,赔率比(OR),置信区间(CI),并采用p值。结果:平均年龄22±3.4岁,主要是混血儿,城市,单身,受过高等教育,和中等社会经济水平的人口。研究发现,与表型C+D相比,表型A+B发生月经少经和高甘油三酯血症的风险更高,差异具有统计学意义(p<0.05)。此外,在生殖变量方面,与表型C+D相比,表型A+B表现出明显更高的抗苗勒管激素(AMH)升高频率。也具有统计学意义(p<0.05)。结论:PCOS的经典表型A和B在厄瓜多尔安第斯妇女中最常见,并且具有较高的胰岛素抵抗风险。无排卵,代谢紊乱,与表型C和D相比,甘油三酯水平升高。种族多样性和社会文化习惯影响这些表型的患病率和临床表现。
    Background: Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder in women of reproductive age. Diagnosis is based on the evidence-based international guideline 2018 and the Rotterdam Consensus to classify PCOS phenotypes. This study aims to characterize the biodemographic, clinical, metabolic, and reproductive variables and their relationship with PCOS phenotypes in a population from the Ecuadorian Andes. Methodology: A cross-sectional study was conducted with a non-random consecutive sample of 92 women who attended the outpatient gynecology and endocrinology clinic at the Hospital of the Technical University of Loja (UTPL)-Santa Inés, Loja, Ecuador, between January 2022 and July 2023. Descriptive statistics, mean calculations, standard deviation, parametric and nonparametric tests, odds ratios (OR), confidence intervals (CI), and p-values were employed. Results: The average age was 22 ± 3.4 years, with a predominantly mestizo, urban, single, highly educated, and medium-high socioeconomic level population. It was identified that phenotypes A + B are at a higher risk of developing oligomenorrhea and hypertriglyceridemia compared to phenotypes C + D, with statistically significant differences (p < 0.05). Furthermore, in terms of reproductive variables, phenotypes A + B exhibit a significantly higher frequency of elevated anti-Müllerian hormone (AMH) compared to phenotypes C + D, also with statistical significance (p < 0.05). Conclusions: The classical phenotypes A and B of PCOS are the most common in Ecuadorian Andean women and carry a higher risk of insulin resistance, anovulation, metabolic disorders, and elevated triglyceride levels compared to phenotypes C and D. Ethnic diversity and sociocultural habits influence the prevalence and clinical manifestations of these phenotypes.
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  • 文章类型: Journal Article
    多毛症是一种常见的内分泌疾病,其病因从良性和特发性疾病到严重的恶性疾病各不相同。多毛症会对生活质量产生负面影响,并对生育能力产生相当大的影响。我们的目的是确定在两个内分泌诊所就诊的女性多毛症的各种原因。
    这项横断面研究是在Baqai糖尿病和内分泌学研究所进行的,卡拉奇和真纳医院,拉合尔从2020年8月到2021年12月,患有多毛症的12-45岁女性被纳入研究。使用改良的Ferriman-Gallwey评分(FG)评估多毛症的严重程度。改良FG评分为8分或更高的患者被认为患有多毛症。
    该研究有113名患者,平均年龄15.50+7.29岁,其中89%患有中度多毛症(FG评分16-25)。多囊卵巢是多毛症的最常见原因。多毛症的常见部位包括背部(83%),武器(74%),臀部(70%),和上腹部(47%)。高BMI(p值<0.01)和高脱氢表雄酮水平与多毛症的严重程度呈正相关(p值为0.006。).
    确定的多毛症的各种原因是多囊卵巢,其次是特发性,甲状腺功能异常,先天性肾上腺增生,和高催乳素血症;因此,所有患有多毛症的女性都应接受潜在的严重和可治愈的病因评估,在开始治疗计划之前。
    UNASSIGNED: Hirsutism is a common endocrine disorder and its etiology varies from benign and idiopathic disorders to serious malignant diseases. Hirsutism creates negative impact on quality of life and considerable effects on fertility. Our objective was to determine the various causes of hirsutism in women presenting at two endocrine clinics.
    UNASSIGNED: This cross-sectional study was conducted at Baqai Institute of Diabetology and Endocrinology, Karachi and at Jinnah hospital, Lahore from August 2020 to December 2021 women between 12-45 years of age with complains of hirsutism were included in the study. Severity of Hirsutism was evaluated using modified Ferriman-Gallwey score (FG). Patients with modified FG score of 8 or more were considered having hirsutism.
    UNASSIGNED: The study had 113 patients with a mean age of 15.50+7.29 years with 89% having moderate hirsutism (FG score 16-25). Polycystic ovaries was the most common cause of hirsutism. Common sites for hirsutism included back (83%), arms (74%), buttocks (70%), and upper abdomen (47%). High BMI (p-value <0.01) and high Dehydroepiandrosterone levels were positively associated with the severity of hirsutism (p-value of 0.006.).
    UNASSIGNED: The various causes of hirsutism identified were polycystic ovaries, followed by idiopathic, thyroid dysfunction, congenital adrenal hyperplasia, and hyperprolactinemia; therefore, all women presenting with hirsutism should be evaluated for potential serious and curable etiologies, before embarking on a treatment plan.
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  • 文章类型: Journal Article
    雄激素过多症是一种情况,其中血液中的雄激素激素水平显着增加,并且可能是肾上腺或卵巢起源。肾上腺雄激素,通常由网状带分泌,是具有弱雄激素活性的类固醇激素。高雄激素血症的原因是多种多样的,可能是内源性和外源性的。雄激素过量影响不同的组织和器官导致临床特征,如痤疮,多毛症,男性化,和生殖功能障碍,如少月症/闭经。尽管雄激素过量很少与肾上腺肿瘤相关,这很重要,因为它可以预测恶性肿瘤。仔细评估雄激素模式,也有明显的高雄激素血症症状的患者,可能是有用的。实验室评估应侧重于测量总睾酮水平,其次是其他雄激素的估计,如脱氢表雄酮和雄烯二酮,并在进一步的管理中使用可视化程序。肾上腺高雄激素血症的治疗主要是手术治疗,考虑到频繁的恶性起源。这篇综述的目的是通过描述肾上腺雄激素类固醇生成的生理机制来阐述和总结肾上腺起源的高雄激素血症的患病率和临床管理。高雄激素血症的临床表现,特别是肾上腺腺瘤和癌中的高雄激素血症,以及将导致我们根据患者的临床表现建立正确的诊断和不同的治疗方案来管理这种情况的诊断方法。
    Hyperandrogenism is a condition in which the levels of androgen hormones in the blood are significantly increased and could be of an adrenal or ovarian origin. The adrenal androgens, normally secreted by the zona reticularis, are steroid hormones with weak androgen activity. The causes of hyperandrogenism are diverse and could be endogenous and exogenous. Androgen excess affecting different tissues and organs results in clinical features such as acne, hirsutism, virilization, and reproductive dysfunction such as oligomenorrhoea/amenorrhoea. Although androgen excess is rarely associated with adrenal tumours, it is important as it could be predictive of malignancy. A careful evaluation of the androgen pattern, also in patients with clear signs of hyperandrogenism, could be useful. Laboratory evaluation should focus on measuring total testosterone levels, followed by the estimation of other androgens such as dehydroepiandrosterone and androstenedione, and using visualisation procedures in the further management. The treatment of adrenal hyperandrogenism is eminently surgical, in consideration of the frequent malignant origin. The aim of this review is to elaborate and summarize the prevalence and clinical management of hyperandrogenism of an adrenal origin by describing the physiological mechanisms of adrenal androgen steroidogenesis, the clinical manifestations of hyperandrogenism with a special reference to hyperandrogenism in adrenal adenomas and carcinomas, and the diagnostic methods that will lead us to establishing the correct diagnosis and different treatment options to manage this condition according to the clinical presentation of the patient.
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  • 文章类型: Journal Article
    多毛症是一种相对常见的疾病,影响约5%至15%的女性。它的定义是女性的终毛过度生长,主要影响依赖雄激素的地区,比如脸,腹部,臀部,和大腿。多毛症可以由多种病因引起,通常不会危及生命。然而,在某些情况下,多毛症可能是更严重的潜在病理的指标,比如肿瘤,这可能需要通过成像进一步阐明。在腹部和骨盆内,肾上腺和卵巢病变是首要考虑因素。本手稿的目的是回顾多毛症的各种腹内和骨盆内原因的病因和影像学特征。
    Hirsutism is a relatively common disorder which affects approximately 5% to 15% of women. It is defined by excessive growth of terminal hair in women, which primarily affects areas dependent on androgens, such as the face, abdomen, buttocks, and thighs. Hirsutism can be caused by a variety of etiologies, which are most often not lifethreatening. However, in some cases, hirsutism can be an indicator of more serious underlying pathology, such as a neoplasm, which may require further elucidation with imaging. Within the abdomen and pelvis, adrenal and ovarian pathologies are the primary consideration. The goal of this manuscript is to review the etiologies and imaging features of various intra-abdominal and intra-pelvic causes of hirsutism.
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  • 文章类型: Case Reports
    卵巢类固醇细胞瘤很少见,占所有卵巢肿瘤的0.1%以下。在多毛症的无数原因中,卵巢肿瘤占报告病例的1%。我们介绍了一名49岁的绝经后妇女因多毛症寻求医疗护理2年的情况。此病例说明了绝经后患者的罕见卵巢病理学与多毛症的临床表现之间的异常和有趣的联系。她的超声检查和MRI显示右附件肿块,实囊性粘连,并伴有薄薄的隔膜。她的实验室检查显示高水平的总睾酮为256ng/ml(8.4-48.1ng/ml),游离睾酮为7.36pg/ml(0.2-4.1pg/ml),而DHEAS-234µg/dl(35.4-256µg/dl)和CA125-15.8U/L(0.0-35U/L)在正常范围内。她接受了剖腹探查术,进行了全腹子宫切除术和卵巢切除术。组织病理学检查和免疫组织化学最终确定了类固醇细胞肿瘤的存在,具体分类为“未指定”(NOS),在右卵巢。
    Ovarian steroid cell tumors are rare, representing less than 0.1% of all ovarian neoplasms. Among the myriad causes of hirsutism, ovarian tumors account for 1% of the reported cases. We present the case of a 49-year-old parous postmenopausal woman who sought medical attention for hirsutism for 2 years. This case illustrates the unusual and interesting connection between rare ovarian pathology and the clinical manifestation of hirsutism in a postmenopausal patient. Her ultrasonography and MRI showed a right adnexal mass of solid-cystic consistency with thin septations. Her laboratory workup revealed high levels of total testosterone of 256 ng/ml (8.4-48.1ng/ml) and free testosterone of 7.36 pg/ml (0.2-4.1 pg/ml), while DHEAS - 234 µg/dl (35.4-256 µg/dl) and CA125 - 15.8U/L (0.0-35 U/L) were in the normal range. She underwent exploratory laparotomy with a total abdominal hysterectomy and oophorectomy. Histopathological examination and immunohistochemistry conclusively established the presence of a steroid cell tumor, specifically classified as \"Not Otherwise Specified\"(NOS), in the right ovary.
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  • 文章类型: Letter
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