Dermatology of androgen-related disorders

Essah, Paulina A.; Wickham, Edmond P.; Nunley, Julia R.; Nestler, John E.

doi:10.1016/j.clindermatol.2006.04.004

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Volume 24, Issue 4 , Pages 289-298, July 2006

Dermatology of androgen-related disorders☆

Paulina A. Essah, MD, MS
- Department of Internal Medicine, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USA
- Corresponding author. Tel.: +1 804 828 9696; fax: +1 804 828 8389.
Edmond P. Wickham III, MD
- Department of Internal Medicine, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USA
Julia R. Nunley, MD
- Department of Dermatology, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USA
John E. Nestler, MD
- Department of Internal Medicine, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USA
- Department of Obstetrics and Gynecology, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USA

Abstract

Hyperandrogenism in women can be caused by various conditions, the most prevalent of which is polycystic ovary syndrome. Common dermatologic manifestations of hyperandrogenism include hirsutism, acne, acanthosis nigricans, and androgenic alopecia. Hirsute women often have increased activity of 5α-reductase, the enzyme that converts the androgen testosterone to its active metabolite, in hair follicles. Likewise, androgens affect the formation of acne by increasing sebum production from sebaceous glands in the skin. The diagnosis of polycystic ovary syndrome includes a complete history, physical examination with emphasis on evidence of androgen excess, and appropriate laboratory investigation to exclude other causes of hyperandrogenism. Treatments for the dermatologic conditions of hyperandrogenism include lifestyle modification, oral contraceptives, antiandrogens, and insulin-sensitizing medications.