Allali-Zerah V, Mahoudeau J
Service d'endocrinologie, CHU, Caen.
Rev Prat. 1993 Nov 15;43(18):2355-62.
Hirsutism is a male pattern of hair distribution in women. It may be caused by hypersecretion of androgens by the adrenal glands or the ovaries and/or by cutaneous sensitivity to circulating androgens due to hyperactivity of 5 alpha-reductase. The degree of hirsutism is evaluated and its cause suspected by physical examination, but the aetiological diagnosis is indicated by plasma testosterone essays: if the testosterone level is above 1.2 ng/mL, investigations must be made to find out whether hirsutism is caused by a virilizing tumour of the ovary or the adrenal gland, or by a congenital adrenal hyperplasia of late presentation. If the testosterone level is below 0.6 ng/mL, hirsutism is idiopathic. Between these two figures the conditions is often idiopathic, but the patient must be investigated for polycystic ovarian dystrophy, adrenal hyperplasia or tumour. Whenever possible, treatment is aetiological, but it is always symptomatic, consisting of electrical depilation of the face and, chiefly, antiandrogens (e.g. Androcur) associated with oestrogens. This treatment usually effective, and it has transformed the outcome of hirsutism, even when the disease is idiopathic.
多毛症是女性出现男性型毛发分布的情况。它可能由肾上腺或卵巢雄激素分泌过多和/或由于5α -还原酶活性过高导致皮肤对循环雄激素敏感所致。通过体格检查评估多毛症的程度并怀疑其病因，但病因诊断需通过血浆睾酮检测来确定：如果睾酮水平高于1.2 ng/mL，必须进行检查以查明多毛症是由卵巢或肾上腺的男性化肿瘤还是迟发性先天性肾上腺增生引起的。如果睾酮水平低于0.6 ng/mL，多毛症为特发性。在这两个数值之间，情况通常为特发性，但必须对患者进行多囊卵巢综合征、肾上腺增生或肿瘤的检查。只要有可能，治疗针对病因，但通常是对症治疗，包括面部的电脱毛，主要是使用与雌激素联合的抗雄激素药物（如安体舒通）。这种治疗通常有效，即使疾病是特发性的，它也改变了多毛症的治疗结果。
