Hirsutism differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: ;Ogheneochuko Ajari, MB.BS, MS [2]

Overview

The diagnosis of hirsutism requires the exclusion of related disorders with peripheral androgen activity. Hirsutism starts shortly after puberty with a slow course and progression.

Differential Diagnosis

Diagnosis Incidence Onset Common symptom
Polycystic ovary syndrome

Idiopathic hirsutism

Congenital adrenal hyperplasia

❑ Ovarian and androgen secreting tumors

❑ Drug induced

HAIR-AN Syndrome

❑ 70-85%

❑ 5-15%

❑ 1-8%

❑ 0.3-0.1%


❑ 0.5-1%


❑ 3-4%

❑ PCOS insidious

❑ Idiopathic hirsutism Insidious
❑ CAH rapid

❑ Tumors rapid



❑ HAIRAN syndrome insidious

❑ Irregular menses, hyperandrogenism, polycystic ovary
❑ No other known cause, normal ovaries, normal anbdrogens


❑ Total testosterone > 200ng and does not respond to treatment

❑ Related to medications (steroids, danazol etc)

❑ Subset of PCOS with insulin resistance and acanthosis nigricans

References

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