METABOLIC
Acromegaly – hirsutism in females
Rook p.2704, 1998,
Sixth Edition
Adrenal hirsutism
Bolognia p.1054, 2003
Chronic illnesses – liver disease, malnutrition
Cushing’s syndrome – hirsutism
Semin Dermatol 3:287–294,
1984; iatrogenic Cushing’s syndrome – lanugo hair of cheeks
Rook p.2705, 1998, Sixth Edition
Hirsutism – hormonal (congenital adrenal hyperplasia,
polycystic ovarian disease, excess ovarian androgen release
syndrome), racial, pregnancy (androgen secreting tumor,
luteoma, lutein cysts)
Bolognia, p.1054, 2003; Rook
p.2895–2899, 1998, Sixth Edition; Obstet Gynecol 44:511–521,
1974; NEJM 288:118–122, 1973
Hyperandrogenism – ovarian source – polycystic ovarian
disease, ovarian tumors; adrenal source – congenital adrenal
hyperplasia – 21-hydroxylase deficiency most common
J Clin Endocrinol Metab 63:418–423, 1986; Cushing’s disease,
adrenal carcinoma, adrenal adenoma
Cancer 44:239–249,
1979; prolactinoma; gonadal dysgenesis (46 XY) – female
genitalia with male skeletal characteristics
Obstet Gyncecol
58:17–23, 1981; androgen therapy, idiopathic hirsutism
Metabolism 37:281–286, 1988; Am J Obstet Gynecol
146:602–610, 1983; Rook p.2897–2899, 1998, Sixth Edition;
Steroids 63:308–313, 1998; Q Med J 43:603–614, 1974
Hyperprolactinemia
Bolognia p.1053, 2003
Hypothyroidism, childhood – hypertrichosis of upper back and
shoulders
Rook p.2708, 1998, Sixth Edition
Liver disease, chronic – trichomegaly
Malnutrition
Menopause – hirsutism
Ghatan p.68, 2002, Second Edition
Multiple sclerosis
Ghatan p.69, 2002, Second Edition
Polycystic ovarian disease
NEJM 352:1223–1236, 2005;
Clin Endocrinol 30:459–464, 1989
Porphyria – porphyria cutanea tarda – decreased hepatic
uroporphyrinogen decarboxylase in sporadic and toxic forms,
and decreased enzyme in all tissues in the hereditary form;
accumulation of water soluble 8-, 7-, 6-, 5-, and
4-carboxylporphyrins; hypertrichosis of cheeks, forehead,
and periorbital regions in about 2/3 of patients with PCT
JAAD 48:161–179, 2003; Rook p.2590, 1998, Sixth
Edition; hepatoerythropoietic porphyria AD 116:307–313,
1980; variegate porphyria – protoporphyrinogen oxidase
deficiency
JAAD 48:161–179, 2003; Wien Klin Wochenschr
50:830–831, 1937; BMJ ii:89, 1955, hereditary coproporphyria
BJD 96:549–554, 1977; Q J Med 46:229–241, 1977;
BJD 84:301–310, 1971; congenital erythropoietic porphyria –
lanugo hair on extremities, terminal hair on face
Semin Liver
Dis 2:154–63, 1982
Precocious puberty – premature adrenarche with molecular
defects of CYP21 gene
J Clin Endocrinol Metab 84:1570–1574,
1999; 37 patients with NF I – optic chasm tumors J Pediar
126:364–367, 1995
Pregnancy – hirsutism
Ghatan p.68,297, 2002, Second Edition
Pretibial myxedema
JAAD 46:723–726, 2002; Rook p.2707,
1998, Sixth Edition; AD 122:85–88, 1986
Starvation
Ghatan p.69, 2002, Second Edition
Thyrotoxicosis
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