Diagnosis and management of the dermatologic manifestations of the polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCOS) is a complex phenotypic spectrum of primarily hyperandrogenic signs and symptoms. PCOS is the most common endocrine disturbance to affect women of reproductive years. Although patients affected are often very disturbed by the cutaneous manifestations, including acne, hirsutism, alopecia, obesity, and acanthosis nigricans, the clinical manifestations of PCOS ramify far beyond the skin. PCOS frequently causes menstrual abnormalities and infertility. Insulin resistance is both pathogenic and a cause of numerous serious health consequences. The accurate diagnosis and recognition of cutaneous hyperandrogenism in PCOS are discussed. The differential diagnosis is reviewed. The work-up and approach to evaluation of patients with PCOS is presented. Although no uniform treatment approach for the management of the cutaneous manifestations of PCOS has been agreed upon, the data on various treatment options and the author's treatment approach to these patients are presented.

Diabetes Mellitus and Polycystic Ovary Syndrome: Beyond A Dermatological Problem

“…syndrome clinic patients were obese, compared with 28% of unselected women with polycystic ovary syndrome identified during screening, and 28% of non-polycystic ovary syndrome controls. Polycystic ovary syndrome symptoms, including hyperandrogenism and oligovulation are exacerbated by obesity [22].…”

“…However, epidemiologic studies need to be conducted to establish the prevalence of acanthosis nigricans in patients with PCOS. Hyperandrogenic insulin-resistant acanthosis nigricans syndrome, a disorder of severe insulin resistance, is comprised of hyperandrogenism, insulin resistance, and acanthosis nigricans and should be excluded when considering a diagnosis of PCOS [1,22].…”

“…It happens in 15% to 25% of the cases. Acne has an overall prevalence in women of about 12%, tends to persist until menopause, and then declines with age [22]. Acne is an androgen-dependent disorder of pilosebaceous follicles (or pilosebaceous unit).…”

“…It is the most common cause of alopecia in women [22]. Typically, AGA diffusely involves the crown, sparing the occiput and the frontal hairline [22].…”

Inositol in women suffering from acne and PCOS: a randomized study

“…Inositol also plays a specific role in the control activity of the metabolism of fats and sugars [14,17,28]. In this context, this molecule may be useful to prevent and correct the pathophysiological mechanisms underlying the metabolic alterations linked to acne.…”