Dermatologic Manifestations of Polycystic Ovary Syndrome

Abstract

Polycystic ovary syndrome (PCOS) affects 5-10% of reproductive-aged women and is one of the most common endocrine disorders in women. The disorder is commonly characterized by elevated levels of androgen and insulin. Women with PCOS may present with a range of signs and symptoms, and face increased risks of reproductive, metabolic, cardiovascular, psychologic, and neoplastic sequelae, particularly if the condition is left unrecognized or untreated. The clinical definition of PCOS has changed in recent years and includes as one of its cardinal criteria the dermatologic manifestations of hyperandrogenism, chiefly hirsutism, acne vulgaris, and androgenetic alopecia. Acanthosis nigricans, a cutaneous sign of hyperinsulinemia, may also be present. These dermatologic features may provide early clinical clues to recognition of PCOS, and treatment of these cutaneous conditions may improve the patient's quality of life and psychologic well-being. The effects of androgen on pilosebaceous units in the skin can vary by anatomic location, producing pathophysiologic effects on hair growth and differentiation, sebaceous gland size and activity, and follicular keratinization. Treatment modalities may include hormonal therapy intended to modulate androgen production and action as well as non-hormonal therapies directed toward specific dermatologic conditions.

Hirsutism, Acne, and Hair Loss: Management of Hyperandrogenic Cutaneous Manifestations of Polycystic Ovary Syndrome

“…Testosterone is converted in the skin by 5-α-reductase to DHT, which leads to sebaceous gland stimulation. Differential expression of 5-α-reductase in sebaceous gland has been offered as an explanation for the majority of patients having normal circulating level of androgens (51).…”

Markers of hyperandrogenism in South Asians with polycystic ovary syndrome

“…The commonest cutaneous manifestations of hyperandrogenemia in PCOS include hirsutism, acne and male pattern of hair loss (androgenic alopecia) (6).…”

Polycystic Ovary Syndrome: Features, Diagnostic Criteria and Treatments

“…As a result of the binding of these hormones to the receptors in the skin, the pilosebaceous unit is stimulated and such stimulation produces sebum with possible development of acne and hairs. Therefore, the skin manifestations of hyperandrogenism in women is seborrhea, with concomitant development of acne, ipertrocosi, or hirsutism [61]. In most important cases of hyperandrogenism, these clinical symptoms are extremely evident and are accompanied by the presence of alopecia, increased muscle mass, clitoromegaly, changes in the voice tone and other organs and tissue manifestations that are affected by the action of androgens [62].…”