Pattern of dermatologic manifestations in polycystic ovarian disease cases from a tertiary care hospital

Abstract

Background: Dermatologists often play a significant role in its management. Cutaneous features of hyperandrogenism in Polycystic ovarian syndrome (PCOS) have varied presentation. Aim of this study was the pattern of dermatologic manifestations in polycystic ovarian disease in northern Indian females.Methods: Patients registering for treatment of polycystic ovarian disease at Dermatology outpatients department during April 2016 to March 2017 formed the study population. Residents interviewed the study subjects at the OPD. General physical examination, systemic examination, breast and pelvic examination, along with detailed dermatological examination were conducting after taking the history. Hormonal analysis was performed after an overnight fasting using enzyme immunoassay.Results: FSH and LH levels were 5.05±1.86 IU/L and 8.14±5.21 IU/L respectively. Testosterone levels were found to be 61.01±25.32 ng/dl. DHEAS levels among them were 130.05±41.21μg/dl. Two commonest cutaneous manifestations were hirsutism and acne seen in 83.8% and 59.5% of subjects. Female pattern hair loss was seen in 45.6% females. Three most frequent hormonal abnormalities noted in our study subjects were raised L/H ratio, testosterone and LH levels seen in approximately 45%, 35% and 21% cases.Conclusions: The cutaneous manifestations of PCOS reserve a major role in its management by dermatologists. A lifestyle modification along with systemic treatment remains mainstay of treatment. Monitoring for the foreseen cardiovascular risks should start early to downgrade the morbidity.

Study of cutaneous manifestations of polycystic ovarian syndrome

“…In this study, mean age of incidence was 23.04 years which was comparable with the studies carried out by Keen et al, Jain et al, while in a study by Mukkamala et al, mean age of incidence was 12.8 years. [7][8][9] In present study, 82% had history of irregular menses and 18% patients had regular menses which is comparable to other studies. 7,9,10 In this study, 28% of the patients were overweight and 24% were obese while in study by Ramanand Among cutaneous manifestations of PCOS, hirsutism was the most common finding occurring in 85% patients similar to study by Keen et al and Jain et al 7,8 In contrast studies by Gowri et al, Hong et al, Fang et al showed acne to be the most common manifestation.…”

“…7 In this study, a statistically significant association was present between hirsutism and serum prolactin levels. Raised prolactin levels were found in 5% patients in study by Keen et al, 13% by Spanda et al, and 8% by Jain et al 7,8,13 However no significant association was found between hirsutism and serum prolactin levels in these studies.…”

Study of cutaneous manifestations in patients with polycystic ovarian syndrome attending a tertiary care centre

“…Similar observations were seen in a study done by Jain et al, where acne vulgaris was found in 59.5% of the study group. 10 The present study with 40 cases of acne vulgaris has 34 patients (85%) with grade II acne vulgaris followed by Acne vulgaris seen in polycystic ovarian syndrome is usually more severe in presentation with nodule and cyst formation and sometimes accompanied by scarring and usually resistant to conventional treatment.…”

“…A study by Jain et al has shown the prevalence of acanthosis to be 35.3% in the polycystic ovarian syndrome patients, which is comparable to the present study. 10 Another study by Singh et al has shown the presence of acanthosis nigricans in 47.1% of patients with the polycystic ovarian syndrome. 9 In the present study, 15 patients (21.4%) were found to have Seborrhea where as in a study by Jain et al seborrhea was observed in 41.9% of the patients.…”

“…9 In the present study, 15 patients (21.4%) were found to have Seborrhea where as in a study by Jain et al seborrhea was observed in 41.9% of the patients. 10 Polycystic ovary syndrome patients may also present with seborrhea which is a common disorder among women with inflammatory acne which is minimally responsive to conventional line of treatment. Acrochordons are noted in 12 patients (17.14%).…”