HirsutismIn the past 10 years hirsutism has been the object of a considerable number of fundamental studies. It provides endocrinologists with an experimental model for the investigation of androgen secretion, metabolism and mechanism of action. Plasma androgen assay, free testosterone measurement, hepatic and extrahepatic androgen metabolic clearance and androgen metabolism in the skin are the different steps which were studied by many groups and represent valuable parameters of the mechanisms of hirsutism. Determination of the origin of androgen oversecretion has become easier by technical progress in differential effiuent venous catheterism, which makes it possible to compare androgens in adrenal or ovarian effiuent veins to their peripheral levels, and to determine the ovarian or adrenal source of the androgen oversecretion as well as the side responsible, essential in the case of tumors. The study of androgen metabolism and the discovery of androgen receptors in the skin confIrm the latter as an actual target cell for androgens. This target cell uses the circulating active androgen, i. e. , testosterone and can also metabolize local inactive androgens into active ones. This is the case of androstenedione and dehy droepiandrosterone which are the two main androgens secreted in women, since women secrete very little testosterone. The capacity of the skin to transform inactive androgens into active ones varies from one individual to another. That would support the concept of variable skin receptivity from one woman to another and from one ethnic group to another. |
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21hydroxylase deficiency abnormal ACTH action activity addition administration androgen receptor androstenedione appears associated Bardin binding Biochem biosynthesis blood cells Clin Endocrinol Metab clinical complete concentration congenital adrenal hyperplasia contrast conversion Cortisol cultured cycle cyproterone acetate decrease defect dehydroisoandrosterone determination dexamethasone diagnosis dihydrotestosterone effect elevated Endocrinology enzyme et al etal excretion fibroblasts function Gynecol hair higher hirsute women hormonal human human skin idiopathic hirsutism important increase incubated inthe Invest Irène Kuttenn levels Lipsett male MauvaisJarvis mechanism menstrual metabolic clearance rate metabolites months Mowszowicz normal women observed obtained oestradiol oestrogens ofthe origin ovarian overproduction Paris partial particularly pathway patients peripheral plasma testosterone polycystic ovaries possible precursors production production rate progesterone protein remains responsible secretion skin specific steroid stimulation studies suggested suppression syndrome TeBG testosterone and androstenedione tissues treatment tumours urinary values virilization vitro Wilson