title: Hirsutism: A Clinico-investigative Study.
abstract: BACKGROUND
  Hirsutism is a common clinical condition characterized by presence of terminal hair at body sites under androgenic influence. Inspite of the significant worldwide prevalence of hirsutism, studies on hirsutism from India are not many.
  
  
  OBJECTIVE
  To assess the etiology of hirsutism and correlate its severity with underlying causes and various hormone levels.
  
  
  METHODS
  In this prospective study, 40 patients of hirsutism enrolled on first come basis were included. All patients underwent detailed clinical assessment and transabdominal ultrasonography. Free and total testosterone, dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, luteinizing hormone, follicle stimulating hormone, prolactin, free tri-iodothyronine, free tetra-iodothyronine, and thyroid stimulating hormone, and sex hormone binding globulin were estimated. Forty age-matched controls without features of hyperandrogenemia were included for the comparison.
  
  
  RESULTS
  Thirteen (32.5%) patients had mild, 52.5% had moderate whereas 15% had severe hirsutism. Positive family history was documented in 42.5% patients. The clinical features found to be associated with hirsutism included acne (55%), menstrual irregularities (40%), acanthosis nigricans (37.5%), obesity (37.5%), and androgenetic alopecia in 27.5% of patients. Polycystic ovarian syndrome (PCOS) was the underlying cause in 70%, non-classical congenital adrenal hyperplasia and hypothyroidism in 7.5% each whereas idiopathic hirsutism was found in 15% patients.
  
  
  CONCLUSIONS
  PCOS was the most common cause of hirsutism found in the instant study. Further, there was positive correlation between severity of hirsutism and free testosterone levels.
authors.affiliation: Department of Dermatology, STD and Leprosy, Dr. RML Hospital and PGIMER, Baba Kharak Singh Marg, New Delhi, India.
authors.forename: Sunny
authors.initials: S
authors.lastname: Chhabra
authors.forename: Ram Krishnan
authors.initials: RK
authors.lastname: Gautam
authors.forename: Bindu
authors.initials: B
authors.lastname: Kulshreshtha
authors.forename: Akhilandeswari
authors.initials: A
authors.lastname: Prasad
authors.forename: Neera
authors.initials: N
authors.lastname: Sharma
keywords: Etiology; hirsutism; polycystic ovarian syndrome