Abstract
Hyperandrogenism, defined as elevated circulating C19 androgen (dehydroepiandrosterone [DHEA], dehydroepiandrosterone sulfate [DHEAS], androstenedione, and testosterone) concentrations, presents with a variety of clinical and biochemical characteristics. Typically, in females, hyperandrogenism is due to increased adrenal and/or ovarian C19 steroid androgen production. Hyperandrogenism is often associated with an underlying endocrine disorder. Common presenting features in adolescent girls include hirsutism, severe acne that is unresponsive to topical medications, and irregular menses. Evaluation includes a thorough history and physical exam followed by laboratory studies to assess for elevated circulating androgens. Suspicion for polycystic ovary syndrome, disorders of steroidogenesis, or an androgen-secreting tumor should prompt referral to pediatric endocrinology for evaluation and management. Topical or cosmetic treatments may benefit some patients with familial isolated hirsutism and acne, a diagnosis of exclusion. Poor response to these treatments should prompt further evaluation to assess for hyperandrogenism with a specialist.
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March, C., Witchel, S. (2021). Acne, Hirsutism, and Other Signs of Increased Androgens. In: Stanley, T., Misra, M. (eds) Endocrine Conditions in Pediatrics. Springer, Cham. https://doi.org/10.1007/978-3-030-52215-5_14
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