ABSTRACT
The diagnosis and management of four cases of dermatological disorders, most of which are related to the endocrine disorder of androgen excess, are presented. Combined oral contraceptives (COCs) may be useful when well-tolerated hormonal therapy and/or when contraception is required. A female patient with androgenetic alopecia or female pattern balding, without underlying hyperandrogenism, was treated with ethinylestradiol/chlormadinone acetate (EE/CMA) 0.03 mg/2 mg for 6 months and experienced stabilization of hair loss (case report 1). A patient who had previously received a COC for an irregular menstrual pattern but again experienced irregular menses and also acne after stopping treatment was diagnosed with acne associated with polycystic ovary syndrome (PCOS) [case report 2]. After 6 month's treatment with EE/CMA 0.03 mg/2 mg, this patient had fewer acne lesions and became eumenorrheic. A third patient who had excess hair since childhood was diagnosed with idiopathic hirsutism (no underlying gynecological or endocrinological disorder was found) and was treated with EE/CMA 0.03 mg/2 mg (case report 3). Less hair growth was reported after 6 months' treatment. Case report 4 describes a patient who presented with oligomenorrhea and acne. She was diagnosed with PCOS with acne, seborrhea and mild hirsutism. Treatment with EE/CMA 0.03 mg/2 mg for 6 months resulted in improvements in her facial acne, seborrhea and hirsutism; she also became eumenorrheic. These four cases illustrate that EE/CMA may be a useful and well tolerated treatment option in the management of patients with dermatological disorders with or without hyperandrogenization.
Subject(s)
Androgens/metabolism , Chlormadinone Acetate/analogs & derivatives , Ethinyl Estradiol/analogs & derivatives , Skin Diseases/drug therapy , Adult , Chlormadinone Acetate/adverse effects , Chlormadinone Acetate/therapeutic use , Contraceptives, Oral, Combined/adverse effects , Contraceptives, Oral, Combined/therapeutic use , Ethinyl Estradiol/adverse effects , Ethinyl Estradiol/therapeutic use , Female , Humans , Skin Diseases/diagnosis , Skin Diseases/physiopathology , Treatment Outcome , Young AdultSubject(s)
Hip Fractures/etiology , Osteoporosis/complications , Pregnancy Complications/diagnostic imaging , Adult , Arthroplasty, Replacement, Hip , Female , Hip Fractures/diagnostic imaging , Hip Fractures/surgery , Hip Joint/diagnostic imaging , Humans , Osteoporosis/diagnostic imaging , Osteoporosis/surgery , Pregnancy , Pregnancy Complications/surgery , RadiographyABSTRACT
OBJECTIVE: To describe a case of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome associated with bilateral myomas in uterine remnants. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 35-year-old woman with MRKH syndrome and pelvic pain, in whom leiomyomas were diagnosed by imaging techniques. INTERVENTION(S): Diagnostic laparoscopy followed by excision of leiomyomas and uterine remnants by laparotomy. MAIN OUTCOME MEASURE(S): Resolution of symptoms and histologic confirmation of the clinic diagnosis. RESULT(S): After a 6-month follow-up period, the patient was asymptomatic. The histologic examination confirmed MRKH syndrome associated with multiple myomas in both rudimentary uteri. CONCLUSION(S): This is an unusual case of MRKH syndrome associated with bilateral leiomyomas. The excision of the tumors with the adjacent uterine remnants is indicated when they are symptomatic.
