目的:我们研究的目的是评估性别确认激素治疗(GAHT)开始后变性人的皮肤病学变化,并研究各种激素制剂是否不同地影响反式AFAB(出生时指定的女性)患者的皮肤病学变化。
方法:在一项多中心前瞻性研究中,484名参与者(193名出生时男性/AMAB和291AFAB)在基线(T0)进行了评估,6(T1)和12个月(T2)后开端GAHT。通过Ferriman-Gallwey(FG)评分评估头发生长,通过全球痤疮评分量表(GAGS),和脱发由诺伍德·汉密尔顿(NH)得分。
结果:在AFAB人群中,随着时间的推移,FG评分和NH等级显着增加,以及71个个体的子样本的GAGS评分(p<0.001)。睾酮(T)十一烷酸酯和酯在T2时显示出较高的头发分布增加。T1与T凝胶相比(p<0.01)。T酯在T1和T2时对GAGS评分修改的影响明显高于T0与T凝胶相比(分别为p=0.021和p=0.003)。在跨性别AMAB人中,FG评分随时间显著下降(p<0.001),尽管51.3%的个体在12个月后仍报告FG评分高于8分。
结论:T治疗可促进毛发生长,AFAB人群的痤疮和脱发患病率,与T凝胶相比,十一酸T和酯对头发生长的影响更大。在AMAB人群中观察到相反的皮肤病学变化。
OBJECTIVE: The aim of our study was to assess dermatological changes in transgender people after the start of gender-affirming hormonal treatment (GAHT) and to investigate whether various hormonal preparations differently affect dermatological changes in trans AFAB (assigned female at birth) people.
METHODS: In a multicenter prospective study, 484 participants (193 assigned male at birth/AMAB and 291 AFAB) were evaluated at baseline (T0), 6 (T1) and 12 months (T2) after the start of GAHT. Hair growth was assessed by the Ferriman-Gallwey (FG) score, acne by the Global Acne Grading Scale (GAGS), and alopecia by the Norwood Hamilton (NH) score.
RESULTS: In AFAB people, a significant increase in FG score and NH grade was observed across time, as well as in GAGS score in a subsample of 71 individuals (p < 0.001). Testosterone (T) undecanoate and esters showed a higher increase in hair distribution at T2 vs. T1 as compared to T gel (p < 0.01). T esters showed a significantly higher impact in GAGS score modifications at T1 and at T2 vs. T0 compared to T gel (p = 0.021 and p = 0.003, respectively). In trans AMAB people, a significant decrease of FG score was observed across time (p < 0.001), although 51.3% of individuals still reported an FG score higher than eight after 12 months.
CONCLUSIONS: T treatment increased hair growth, acne and alopecia prevalence in AFAB people, with T undecanoate and esters influencing hair growth more than T gel. Opposite dermatological changes were observed in AMAB people.