Iatrogenic hirsutism

Introduction to iatrogenic hirsutism The growth of hair in a wide range of parts such as the trunk, limbs, and occasional face caused by certain therapeutic drugs. The hair is thicker than the baby's hair, but is thinner than the final hair, and can be as long as 3 cm between the two. After stopping the drug, it can return to normal within 6 months to 1 year. The iatrogenic hirsutism should be distinguished from the iatrogenic hirsutism of the iatrogenic women, who are all or partially men's secondary sexual hair. The distribution of hair is usually irreversible and does not recover after stopping the drug. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: iatrogenic hirsutism, hirsutism, hirsutism

Etiology of iatrogenic hirsutism

(1) Causes of the disease

The main causes of iatrogenic hirsutism are the following:

Diphenylhydantoin (15%):

Children with epilepsy have hirsutism 2 to 3 months after taking the drug. They start from the extremities and develop to the trunk and face. After stopping the drug, they can subside, but sometimes they do not retreat. The distribution type and hairiness caused by head trauma. The symptoms are similar.

Cortisone (15%):

Patients with large and long-term cortisone treatment may develop hirsutism, the most prominent in the forehead, ankle, and cheeks. It can also occur on the back and upper extremity, but it is lighter and subsides within a few months after stopping the drug. Local topical corticosteroids can also cause hairy hair.

Streptomycin (15%):

Children with tuberculous meningitis treated with streptomycin have hirsutism, hairy patterns and time of occurrence are the same as phenytoin, and can also resolve after stopping.

Penicillamine (10%):

It can cause the mane of the trunk and limbs to grow thicker.

Psoralen (10%):

Oral psoralen and phototherapy can cause hyperpigmentation and hairiness.

Diazoxide (diazoxide) (10%):

Directly acts on vascular smooth muscle, relaxes it to lower blood pressure, and inhibits insulin secretion from islet cells, thereby raising blood sugar, commonly used to treat hypertensive crisis, also used in children with idiopathic hypoglycemia, or due to islet Severe hypoglycemia caused by cell tumors, more than 50% of children can cause hirsutism, but it is not common in adults.

Minoxidil (minoxidil) (5%):

It is a powerful vasodilator for the treatment of high blood pressure. It can take more than 10mg per day and even for several months. It can cause hirsutism. It is also used directly on the skin to stimulate hair growth. Therefore, it may be related to increased blood flow to the skin.

Benzoprofen (5%):

It can cause growth of hairy and nail growth.

Cyclosporin (6%):

Most kidney transplant patients develop hirsutism after receiving this immunosuppressive agent, and graft-versus-host disease also occurs after administration of this drug.

(two) pathogenesis

The pathogenesis is still unclear.

Iatrogenic hirsutism prevention

There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.

Pay attention to the following considerations:

1, the mood is not comfortable, there are long-term anger and depression, anxiety, anxiety and other negative emotional stimuli.

2, the diet structure is unreasonable, there are bad habits of eating greasy, spicy food and excessive drinking, and more often accompanied by long-term constipation.

3, the pace of life is disordered, there is a long history of staying up late.

4, usually improper care of the skin, hair, use cosmetics or toiletries that are not suitable for their own conditions.

5, treatment errors, incorrect extraction, hair removal methods or too frequent pull, hair removal and so on.

Iatrogenic hirsutism complications Complications iatrogenic hirsutism women hirsutism hirsutism

The cause of this disease is usually accompanied by an increase in androgen or adrenocortical hormone. For women with elevated androgen, it can cause hairiness and menstrual disorders and obesity caused by inhibition of estrogen. After the adrenal cortex hormone is increased, centripetal obesity can occur, forming a special appearance of the full moon and buffalo back. It can also increase blood pressure and abnormal distribution of blood potassium.

Symptoms of iatrogenic hirsutism Common symptoms Hair abnormal hair Increased hairy facial hairy lumbosacral skin hairy...

With reference to the cause, there must be a medical history and a hairy appearance after taking the medicine.

Iatrogenic hirsutism

Check the items in accordance with the actual situation of the patient.

Testosterone (T), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and DHEAS should be checked first. Free testosterone (FT), 17-hydroxyprogesterone Check, first observe whether T is elevated, the initial consideration is adrenal or ovarian, if LH is elevated or the ratio of LH to FSH is increased, it may be polycystic ovary syndrome, if the DHEAS is elevated, often adrenal DHEAS normal T is significantly elevated, mostly ovarian, it is best to check PRL at the same time to rule out high prolactin-induced anovulation. If hairy progresses rapidly, consider the secretion of androgen-secreting tumors, the total T level is higher than 7nmol/L (200ng/dl).

1.B-ultrasound

Ovarian tumors can be found basically, and ovarian enlargement or polycystic ovary can also be found, but the diagnosis rate is lower for adrenal diseases.

2.CT or MRI

It is sensitive to adrenal tumors and can also be located. It can also show contralateral adrenal gland status, but sometimes misdiagnosis of adrenal hyperplasia is also of great value in the diagnosis of ovarian tumors.

3. Laparoscopy

If there is no abnormality in the non-invasive examination, and the laboratory examination is highly suggestive of ovarian tumors (such as total T > 7mmol / L), laparoscopic diagnosis should be performed, and preparation for laparoscopic resection of the tumor should be done.

Diagnosis and diagnosis of iatrogenic hirsutism

According to clinical manifestations, the characteristics of skin lesions can be diagnosed.

Iatrogenic hirsutism should be distinguished from iatrogenic hirsutism, which is all or part of the distribution of men's secondary sexual hair, usually irreversible and does not recover after discontinuation.

It should be differentiated from polycystic ovary syndrome, adrenal hyperplasia, adrenal adenoma, adrenocortical carcinoma, ovarian tumor and ectopic ACTH syndrome. Such as polycystic ovary syndrome, there may be obesity, amenorrhea, infertility, clitoris hypertrophy, hemorrhoids, breast dysplasia and hirsutism and other symptoms and signs. Such as adrenal adenoma hirsutism, may also have centripetal obesity, high blood pressure, hemorrhoids, amenorrhea, multi-blood, skin purple, full moon face and osteoporosis, etc., its cortisol levels increased, urine 17- Increased KS and 17-OHCS and elevated urinary cortisol can be used for differential diagnosis.

Less common congenital adrenal hyperplasia is more easily recognized by people with amphoteric malformations. Delayed and invisible patients often develop after puberty, allele mutations, clinical manifestations only hairy and vaginal di mild hypertrophy, it is not easy to differentiate from idiopathic hirsutism.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.