1/2. Mild cutaneous manifestation in two young women with extraordinary hyperandrogenemia.hyperandrogenism with hyperandrogenemia should be considered in those with severe acne of sudden onset or conspicuous male-pattern baldness with hairline recession, although the majority of female patients with acne or androgenetic alopecia possess no endocrine disorder. Herein we describe on the contrary 2 young women with primary amenorrhea displaying prominent hyperandrogenemia but subtle cutaneous manifestation. The first one presenting vertical alopecia had an elevated level of serum dehydroepiandrosterone sulfate (>800 microg/dl) and was suspected to be a case of late-onset, non-classical adrenal hyperplasia. The second case with mild acne had a soaring serum level of total testosterone >9,000 ng/dl derived from an androgen-secreting adrenal adenoma overexpressing steroidogenic acute regulatory protein, P450 side-chain cleavage enzyme and aromatase. A careful patient history and a complete physical examination are mandatory in each individual female case with acne or alopecia. The possibility of adrenal tumor should be explored in patients with escalated circulating testosterone.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/2. Apparent self-limited androgen excess in a 4 year-old male.We describe a 4 year-old male with significant virilization, but no source of endogenous or exogenous androgen excess after extensive testing. Evaluation of androgen receptor function, 5 alpha-reductase activity, steroid hormone secretion patterns, and androgen metabolite concentrations were also within the normal range. Over a 10 month period there was spontaneous resolution of the physical and behavioral signs of androgenization. We postulate a self-limited process of androgen production which may represent a yet undefined pattern of sexual precocity in males.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |