hair growth
Introduction
Introduction Hyperplasia and hirsutism are excessive hair growth in the body's non-androgen-dependent parts, which may be congenital or acquired, general or local. However, under normal circumstances, different race hairs may vary, not only in different colors, but also in different quantities. For example, Greek males have a lot of chest hair, while Chinese men have fewer chest hairs. Unlike hairy hyperplasia, hirsutism refers to excessive hairiness in females, which occurs only in the androgen-dependent parts, and the slender bristles become thick and short hairs. Female hair is too much, with masculine performance, affecting the appearance.
Cause
Cause
Common causes of hirsutism are: idiopathic hirsutism, polycystic ovary syndrome, ovarian tumor, hypercortisolism, adrenal gland abnormalities, diazoxide, phenytoin, androgen.
1. Familial hereditary hirsutism.
2. Adrenal hirsutism
(1) Adrenal tumors.
(2) Cushing's disease.
(3) masculinization of congenital adrenal hyperplasia.
3. Central hirsutism
(1) cerebral hirsutism.
(2) hypothalamic and pituitary hirsutism.
4. Ovarian hirsutism
(1) Polycystic ovary syndrome.
(2) Ovarian tumors.
5. Drug-induced hirsutism.
6. Insulin resistance syndrome and hirsutism.
7. Idiopathic hirsutism.
8. Other properties of hirsutism such as hypothyroidism and hairy, menopausal hairy and gestational hairy are mostly temporary hirsutism.
Examine
an examination
Related inspection
Hair hair mineral inspection
The increase in the number of female hair, quality and distribution changes are male characteristics, such as the appearance of whiskers, thick eyebrows, increased hair in the neck area, chest and back, lower abdomen, perineum, forearms, thighs and other areas sensitive to androgen response.
Diagnosis
Differential diagnosis
1. Familial hereditary hirsutism hirsutism can be caused by elevated plasma testosterone levels or testosterone conversion to dihydrotestosterone in hair follicles. In female patients with familial hereditary hirsutism, the body hair is slightly more than normal, thin and long, distributed as male, may be hair follicles sensitive to androgen, receptor-rich, normal amount of androgen or exogenous to the body Both small doses of androgen can cause hirsutism.
2. Adrenal hirsutism
(1) Adrenal tumors: Adrenal adenomas or adrenocortical carcinomas can synthesize androgen androgen, such as androstenedione, dehydroepiandrosterone and testosterone, causing hirsutism and masculinization.
(2) Cushing's disease: increased ACTH secretion causes bilateral adrenal hyperplasia, hypercortisolism, ACTH is mostly derived from pituitary basophils or chromophobe cells, less from ectopic ACTH syndrome, ie Some malignant tumors such as lung cancer. Adrenal hyperplasia often secretes the growth of adrenal androgen, which causes amenorrhea, hairy and masculine performance in women.
(3) masculinization of congenital adrenal hyperplasia: lack of P450C2l-hydroxylase in the adrenal gland, deficiency of P450C11-hydroxylase and lack of 3-HSD, a decrease in the synthesis and reduction of adrenal cortisol, which may cause an increase in the compensatory secretion of ACTH. Lead to excessive androgen secretion and adrenal hyperplasia, at this time young women patients may have varying degrees of hirsutism and masculine manifestations, that is, amenorrhea, larynx and low voice and other abnormalities.
3. Central hirsutism
(1) cerebral hirsutism: after brain damage such as encephalitis, multiple sclerosis, pineal tumors and intracranial hyperplasia, some patients may have increased androgen secretion, and induced hirsutism.
(2) hypothalamic and pituitary hirsutism: hypothalamic and pituitary tumors, pituitary eosinophilic adenoma, basophil hyperplasia and adenoma, etc., can cause adrenal hyperplasia, and cause hirsutism, acromegaly Symptoms can also have hirsutism.
4. Ovarian hirsutism
(1) Polycystic ovary syndrome: is the cause of more common hirsutism, may be accompanied by Yin di hypertrophy. Due to the inhibition of aromatase, 3-hydroxysteroid dehydrogenase and the enhancement of P450C, 17 and 20-lyase activity in polycystic ovary, the follicular cells proliferate, and the synthesis of androgens increases, resulting in hirsutism and masculinization.
(2) ovarian tumors: such as ovarian germ cell tumor, portal cell tumor, ovarian cord tumor and adrenal residual cell tumor can synthesize and secrete androgen, causing hirsutism and masculinity.
5. Drug-induced hirsutism Some drugs such as phenytoin, diazoxide, minoxidil and cyclosporine in non-hormonal drugs, hormone drugs such as prednisone, etc. take too long, when the dose is large Can cause hirsutism.
6. Insulin resistance syndrome and hirsutism There are three types of insulin resistance syndrome caused by hereditary insulin receptor deficiency:
1 insulin resistance type A, its clinical manifestations are more diabetes, acanthosis nigricans and elevated levels of androgen.
2 lipodystrophy diabetes can have diabetes, lipoatrophy, elevated triglycerides, acanthosis nigricans and elevated levels of androgen.
3 Dwarfism manifested as stagnation in the uterus, fasting hypoglycemia, dwarfism and elevated androgen levels. These hyperinsulinemia can cause the proliferation of follicular cells and the synthesis and secretion of androgen, resulting in hirsutism and masculinity.
7. Idiopathic hirsutism is more common in clinical practice. The patient has no genetic family history, no organic disease, no medication history, and the main manifestations of hirsutism can not find the cause, and the examination is normal. It belongs to idiopathic hirsutism.
(1) Congenital fetusesis: This disease is also known as congenital systemic hirsutism. It is found in children under 10 years old. It has excessive hair on the body and face. It is filamentous and may be accompanied by abnormal tooth development. It is a rare disease. Autosomal dominant inheritance. Such children are commonly known as "hair boy", "dog face child" or "wolf man", and have been reported at home and abroad. The patient's fetal hair persists and is not replaced by terminal hair.
(2) Acquired polypsils: This disease is less common than congenital, more women than men, sudden increase of filamentous hair throughout the body, or limited to local, rapid hair growth, 2.5cm per week, length up to 10 cm the above. More often combined with malignant tumors, often breast, lung, gallbladder, pancreas, colon, rectum, bladder, ovary or uterine cancer. When the tumor is removed, the increase in hair can be reduced.
(3) Congenital local hair hyperplasia: The disease occurs at or after birth, there is no need for a good hair, hairy skin with or without sputum. Often associated with some sputum, known as sputum-like hair hyperplasia, such as Becker , thick and long hair. Spina bifida and tibial hair hyperplasia are seen in children, with a cluster of thick or fine hairs with spina bifida in the lumbosacral region.
Finger hyperplasia is more common in men, occurring on the dorsal side of the 2nd, 3rd, 4th, and 5th fingers (toe) and is autosomal dominant. Elbow hyperplasia, also known as multiple elbow syndrome, is a hairy elbow after birth. After 5 years of age, hairy hair begins to decrease, which can be autosomal dominant or recessive. Hair ears, also known as hairy ears, mainly occur in men. The short hairs of the external auditory canal become thick and long, extending out of the ear wheel, which is autosomal dominant.
(4) Acquired local hyperplasia: often occurs after skin inflammation or chronic irritation, such as friction, bites, vascular obstruction, arthritis, mucus edema of the axilla, varicose veins of the lower extremities or eczema.
(5) iatrogenic hairy hyperplasia: long-term application of certain drugs can cause hairy, found in the trunk, limbs, and occasionally on the face. The hair has a diameter between the baby's hair and the terminal hair and can be as long as 3 cm. Generally, after half a year to one year, the hair can be recovered. Common drugs are phenytoin, streptomycin, prednisone, penicillamine, psoralen, minoxidil and the like.
The increase in the number of female hair, quality and distribution changes are male characteristics, such as the appearance of whiskers, thick eyebrows, increased hair in the neck area, chest and back, lower abdomen, perineum, forearms, thighs and other areas sensitive to androgen response.
