跨性别者激素治疗对皮肤结局的影响：一项多中心前瞻性研究（ENIGI）。
Effects of hormonal treatment on dermatological outcome in transgender people: a multicentric prospective study (ENIGI).
机构信息
Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, Florence, Italy.
Psychiatric Unit, Department of Health Sciences, University of Florence, Florence, Italy.
出版信息
J Endocrinol Invest. 2023 Apr;46(4):779-786. doi: 10.1007/s40618-022-01944-x. Epub 2022 Nov 8.
PURPOSE
The aim of our study was to assess dermatological changes in transgender people after the start of gender-affirming hormonal treatment (GAHT) and to investigate whether various hormonal preparations differently affect dermatological changes in trans AFAB (assigned female at birth) people.
METHODS
In a multicenter prospective study, 484 participants (193 assigned male at birth/AMAB and 291 AFAB) were evaluated at baseline (T0), 6 (T1) and 12 months (T2) after the start of GAHT. Hair growth was assessed by the Ferriman-Gallwey (FG) score, acne by the Global Acne Grading Scale (GAGS), and alopecia by the Norwood Hamilton (NH) score.
RESULTS
In AFAB people, a significant increase in FG score and NH grade was observed across time, as well as in GAGS score in a subsample of 71 individuals (p < 0.001). Testosterone (T) undecanoate and esters showed a higher increase in hair distribution at T2 vs. T1 as compared to T gel (p < 0.01). T esters showed a significantly higher impact in GAGS score modifications at T1 and at T2 vs. T0 compared to T gel (p = 0.021 and p = 0.003, respectively). In trans AMAB people, a significant decrease of FG score was observed across time (p < 0.001), although 51.3% of individuals still reported an FG score higher than eight after 12 months.
CONCLUSION
T treatment increased hair growth, acne and alopecia prevalence in AFAB people, with T undecanoate and esters influencing hair growth more than T gel. Opposite dermatological changes were observed in AMAB people.
目的
本研究旨在评估跨性别者在开始性别肯定激素治疗（GAHT）后的皮肤变化，并探讨不同的激素制剂是否会对跨性别女性（出生时被指定为女性，简称 AFAB）的皮肤变化产生不同的影响。
方法
在一项多中心前瞻性研究中，484 名参与者（193 名出生时被指定为男性/AMAB，291 名 AFAB）在开始 GAHT 后的基线（T0）、6 个月（T1）和 12 个月（T2）进行评估。毛发生长通过 Ferriman-Gallwey（FG）评分评估，痤疮通过全球痤疮分级量表（GAGS）评估，脱发通过 Norwood Hamilton（NH）评分评估。
结果
在 AFAB 人群中，FG 评分和 NH 分级在整个时间内均显著增加，在 71 名个体的 GAGS 评分亚组中也观察到显著增加（p<0.001）。与 T 凝胶相比，十一酸睾酮和酯类在 T2 时的毛发分布增加更高（p<0.01）。与 T 凝胶相比，T 酯类在 T1 和 T2 时对 GAGS 评分的改变具有更高的影响（p=0.021 和 p=0.003）。在 AMAB 人群中，FG 评分随时间显著降低（p<0.001），尽管 12 个月后仍有 51.3%的个体 FG 评分仍高于 8。
结论
T 治疗增加了 AFAB 人群的毛发生长、痤疮和脱发的患病率，十一酸睾酮和酯类对毛发生长的影响大于 T 凝胶。在 AMAB 人群中观察到相反的皮肤变化。
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