Clinico-investigative attributes of 122 patients with hirsutism: A 5-year retrospective study from India.

Content Provider	Europe PMC
Author	Mahajan, Vikram K Singh Chauhan, Pushpinder Chandel, Monika Singh Mehta, Karaninder Karan Singh, Vijay Sharma, Anuj Sharma, Reena Sharma, Jyotshna Hooda, Sheenam Raj Verma, Yog Sharma, Hitender
Copyright Year	2020
Abstract	BackgroundHirsutism is common across ethnicities and a significant cause of negative self-esteem from presumptive loss of femininity. It remains understudied in Indian patients.ObjectiveWe studied the clinical and investigative attributes of patients with hirsutism.MethodsThe medical records of 233 patients with hirsutism diagnosed between 2014 and 2019 were analyzed retrospectively.ResultsThe complete records of 122 patients age 14 to 45 years were available. Approximately 32% were adolescents, and 50% patients were age 21 to 30 years. The mean ± standard deviation modified Ferriman–Gallway (mF–G) score was 17.95 ± 10.58, and hirsutism was graded zero/mild in 57.4% patients. Polycystic ovaries were present in 29.5% of patients. Serum-free testosterone levels were elevated in 16.4% of patients. Associated signs of clinical hyperandrogenism, such as acne, obesity, acanthosis nigricans, and menstrual irregularities, were present in 12 patients (9.8%). Familial hirsutism occurred in 13% of patients and was idiopathic in 10.7% of patients. Significantly more patients (47.7% vs. 27.9%) with severe hirsutism did not complete investigations compared with those with mild hirsutism (45.9% vs. 21.6%), which may be due to the high cost of investigative work-up (as often stated by many patients) compared with periodic depilation.LimitationsThe mF–G score is a visual and subjective scale, and its validity remains limited by interobserver variations. The score’s cut-off values may vary among races/ethnicities. A small number of patients and the retrospective study design are other limitations.ConclusionHirsutism of polycystic ovary syndrome or idiopathic origin is not uncommon in Indian women. Hirsutism of adrenal or thyroid origin remains uncommon. Self-referral and high cosmetic concerns for facial hair were common in adolescents and young unmarried patients, and the majority had an mF–G score of < 8 to 16. Cut-off values for the mF–G score specific to our population assigning higher than current mF–G value to facial hair are highly desirable.
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Journal	International Journal of Women's Dermatology [Int J Womens Dermatol]
Volume Number	7
DOI	10.1016/j.ijwd.2020.11.007
PubMed Central reference number	PMC8243119
Issue Number	3
PubMed reference number	34222577
e-ISSN	23526475
Language	English
Publisher	Elsevier
Publisher Date	2020-12-05
Access Restriction	Open
Rights License	This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). © 2020 Published by Elsevier Inc. on behalf of Women's Dermatologic Society.
Subject Keyword	Acanthosis nigricans Acne India Modified Ferriman–Gallwey score Hyperandrogenism Polycystic ovarian disease
Content Type	Text
Resource Type	Article
Subject	Dermatology