الفهرس 
Polycystic ovary syndrome (PCOS)Only 14 pages are availabe for public view
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Abstract
Women with Polycystic Ovary Syndrome (PCOS) present with either a history of irregular menstrual cycles, clinical signs or biochemical parameters suggestive of elevated androgen levels. Because of the inconsistency in clinical presentation, medical advice is sought from gynaecologists, endocrinologists or dermatologists.
The current definition of PCOS is based on Rotterdam consensus meeting (2004). It defines the syndrome as presence of any two of the following three criteria: (1) Menstrual irregularity: Oligomenorrhoea and/or anovulation, (2) Clinical (Acne or Hirsutism) and/or biochemical Hyperandrogenemia, and (3) PCOS on ultrasonography. Excessive LH secretion relative to FSH was the first laboratory abnormality identified in classic PCOS. It is thought to play a role in the pathogenesis of PCOS by increasing androgen production and secretion by ovarian theca cells.
PCOS produces symptoms in approximately 5% to 10% of women of reproductive age (12–45 years old). PCOS symptoms have a gradual onset. The symptoms and severity of the syndrome vary greatly among affected women.
Approximately 60% to 70% of women with PCOS have hirsutism. Up to 37% of women with moderate to severe acne meet the diagnostic criteria for PCOS. Acne commonly results from the local effects of increased androgen receptor sensitivity within the pilosebaceous unit. Acanthosis nigricans is most commonly observed in the neck and intertriginous areas, such as armpits, groins and inframammary region. The prevalence of acanthosis nigricans in adult obese patients has been estimated at 74%. Despite being mostly associated with obesity, PCOS, acanthosis nigricans may be associated with genetic diseases, drug reaction and malignancies.
As regards the prevalence of alopecia in women with PCOS, it is relatively low compared with other androgenic symptoms, an association with polycystic ovaries has been reported. The diagnosis should exclude other causes of hair loss in women, such as telogen effluvium, alopecia areata, anagen loss syndrome and trichotillomania.
PCOS is one of the most common gynecological disorders of reproductive aged women with cutaneous manifestations; therefore, it may be first diagnosed by a dermatologist.
This study aimed to evaluate the prevalence of specific cutaneous disorders in patients with poly cystic ovary syndrome.
The present study included (134) female patients that was diagnosed as having polycystic ovary syndrome according to Rotterdam criteria. Patients were included sequentially in the study provided that they met the inclusion criteria and lacked the exclusion criteria. All patients were exposed to comperhensive skin examination and transvaginal or abdominal ultrasonography.
The current study showed a very high prevelance of hirsuitism among PCOS patients 93%, acne among PCOS patients 49.2%, acanthosis nigricans in 53.7% but low prevelance of androgenetic alopecia and seborrhic dermatitis 35.8%, 27.6% respectively.
Cutaneous manifestations could be the first sign of PCOS, therefore, we strongly believe that dermatologists should be more aware of this disease and understand differences between ethnicities. Thus dermatologist might have a leading role in the early detection of PCOS in young women.
Acne, Hirsutism and Acanthosis Nigricans were the most common cutaneous manifestation to be found.
Our finding of positive correlation between hirsuitism and hormonal abnormalities (increased LH/FSH ratio and total testosterone) upholds and further indicates that hirsuitism is an important indication for a reproductive and metabolic workup in suspected cases of PCOS.
There was also a positive correlation between acne and hormonal abnormalities (increased LH/FSH ratio and total testosterone) which indicated that acne is a potential indication for a reproductive and metabolic workup in suspected cases of PCOS.There was a significance difference between patients with and without acanthosis nigricans regarding LH/FSH ratio and total testosterone.
On the other hand, there were no significance differences between patients with and without androgenetic alopecia and seborrhic dermatitis regarding same hormonal profile.
Our study demonstrated that the prevelance of cutaneous manifestations in PCOS shows a clinical spectrum ranging from one to multiple findings. Each finding has a characteristic association and correlation with hormonal abnormalities.