Deparment of Dermatology, Hospital Municipal of Badalona, Badalona, Barcelona, Spain.
Am J Clin Dermatol. 2011 Sep 6;12 Suppl 1(Suppl 1):13-9. doi: 10.2165/1153875-S0-000000000-00000.
The diagnosis and management of four cases of dermatological disorders, most of which are related to the endocrine disorder of androgen excess, are presented. Combined oral contraceptives (COCs) may be useful when well-tolerated hormonal therapy and/or when contraception is required. A female patient with androgenetic alopecia or female pattern balding, without underlying hyperandrogenism, was treated with ethinylestradiol/chlormadinone acetate (EE/CMA) 0.03 mg/2 mg for 6 months and experienced stabilization of hair loss (case report 1). A patient who had previously received a COC for an irregular menstrual pattern but again experienced irregular menses and also acne after stopping treatment was diagnosed with acne associated with polycystic ovary syndrome (PCOS) [case report 2]. After 6 month's treatment with EE/CMA 0.03 mg/2 mg, this patient had fewer acne lesions and became eumenorrheic. A third patient who had excess hair since childhood was diagnosed with idiopathic hirsutism (no underlying gynecological or endocrinological disorder was found) and was treated with EE/CMA 0.03 mg/2 mg (case report 3). Less hair growth was reported after 6 months' treatment. Case report 4 describes a patient who presented with oligomenorrhea and acne. She was diagnosed with PCOS with acne, seborrhea and mild hirsutism. Treatment with EE/CMA 0.03 mg/2 mg for 6 months resulted in improvements in her facial acne, seborrhea and hirsutism; she also became eumenorrheic. These four cases illustrate that EE/CMA may be a useful and well tolerated treatment option in the management of patients with dermatological disorders with or without hyperandrogenization.
本文介绍了 4 例皮肤科疾病的诊断和治疗,这些疾病大多与雄激素过多引起的内分泌紊乱有关。口服避孕药(COC)在耐受良好的激素治疗和/或需要避孕时可能有用。一位患有雄激素性脱发或女性型秃发(无潜在的高雄激素血症)的女性患者,接受了炔雌醇/氯地孕酮(EE/CMA)0.03 毫克/2 毫克治疗 6 个月,脱发得到稳定(病例报告 1)。一位曾因月经不规则而接受 COC 治疗但停药后再次出现月经不规则和痤疮的患者,被诊断为多囊卵巢综合征(PCOS)相关痤疮(病例报告 2)。在接受 EE/CMA 0.03 毫克/2 毫克治疗 6 个月后,该患者痤疮皮损减少,月经恢复正常。第三位患者自童年起就有多毛症,被诊断为特发性多毛症(未发现妇科或内分泌疾病),接受 EE/CMA 0.03 毫克/2 毫克治疗(病例报告 3)。治疗 6 个月后,毛发生长减少。病例报告 4 描述了一位月经稀少和痤疮的患者。她被诊断为伴有痤疮、皮脂溢和轻度多毛的 PCOS。接受 EE/CMA 0.03 毫克/2 毫克治疗 6 个月后,她的面部痤疮、皮脂溢和多毛症均有改善,月经也恢复正常。这 4 个病例表明,EE/CMA 可能是一种有用且耐受良好的治疗选择,可用于治疗伴有或不伴有高雄激素血症的皮肤科疾病患者。