Mangold R, Heilmann V, Rossmanith W G
Universitäts-Frauenklinik Ulm.
Zentralbl Gynakol. 1998;120(10):515-7.
Virilization in postmenopausal women is suspicious for androgen-secreting adrenal or ovarian tumors; however, iatrogenic androgenization needs to be additionally considered. Here we report on a 64-year-old patient who presented clinically with progressive signs of virilization. An adrenal source of androgen excess was excluded, and the patient strictly denied the use of any androgenic medication. Thus, elevated serum levels of testosterone were suspicious of ovarian hyperandrogenism. Shortly before planned surgical exploration, the clinical finding of an extensive vulvar lichen sclerosus pointed towards a possible long-term use of testosterone-containing cremes for symptomatic relief of this disease. Apparently, the patient did not consider the mere topical application of potent agents to be a medication. This case demonstrates that besides adrenal or ovarian sources of hyperandrogenism, iatrogenic androgenization has to be considered.
绝经后女性出现男性化表现应怀疑存在分泌雄激素的肾上腺或卵巢肿瘤；然而，还需要额外考虑医源性雄激素化。在此，我们报告一名64岁的患者，其临床上表现出进行性男性化体征。排除了雄激素过多的肾上腺来源，且患者坚决否认使用过任何雄激素类药物。因此，血清睾酮水平升高怀疑为卵巢高雄激素血症。在计划进行手术探查前不久，广泛外阴硬化性苔藓的临床发现提示可能长期使用含睾酮的乳膏来缓解该疾病的症状。显然，患者并不认为仅仅局部应用强效药物算是用药。该病例表明，除了肾上腺或卵巢来源的高雄激素血症外，还必须考虑医源性雄激素化。
