Clinical Profile of Hirsutism Cases at King Fahd Hospital of the University (KFHU), 1995-1999

Abstract

This cross-sectional study reviews the medical records of hirsute females seen at the Dermatology Clinic, King Fahd Hospital of the University (KFHU), Al-Khobar, Eastern Province, Saudi Arabia, during a five-year period (January 1, 1995 - December 31, 1999). The data from the medical records was collected and summarized in a specially designed format. The final analysis of the results was done using Statistical Package for Social Sciences (SPSS for windows). In this study we reviewed the demographic, clinical patterns, shed light on possible etiological factors, and determined the attempted treatments of 73 female patients with hirsutism. The calculated percentage of hirsutism in females in our Dermatology Clinic was 2.25%. Saudi nationals represented 86.3% of patients and non-Saudi patients constituted 13.7% and these were expatriates from various nationalities. The mean age of onset of hirsutism was 22.1 + 7.59 years. The duration of hirsutism in these patients varied from 1- 12 years. The mean age of menarche was 12.7 +1.02 years; 54.8 were singles, the rest were either married or divorced, and from those who ever married 69.7% had children. More than half of these hirsute patients (58.9%) gave a history of menstrual irregularity, while positive family history of hirsutism was documented in 35.6% of the patients. All the women in the sample had a gradual onset and progression of their hirsutism, and no major clinical features of systemic virilization such as deepening of voice, cliteromegaly, muscular hypertrophy, or breast atrophy were documented in any. The pattern of hair distribution is shown to be affecting androgen- dependent sites which are the chin, cheeks, upper lip, anterior neck, chest, arms, upper thighs and lower abdomen. The commonest site of involvement was the chin (89%). Acne, seborrhea and androgenetic alopecia were the androgenic features associated with hirsutism, and the other associated conditions included obesity, acanthosis nigricans, diabetes mellitus and galactorrhea. The possible causes of hirsutism in our study were polycystic ovarian disease (24.7%), hyperprolactinemia (5.5%), drug-induced hirsutism (2.7%), hypothyroidism (1.4%) and idiopathic hirsutism (65.7%). The modalities of therapy attempted in these hirsute patients were electrolysis, cyproterone acetate alone, cyproterone acetate combined with ethinyl estradiol, spironolactone, dexamethasone, bromocriptine and laser. This preliminary and retrospective study reviews the clinical profile of hirsutism cases and to the best of our knowledge is the first of its kind to be conducted in a dermatology clinic in Eastern Province of Saudi Arabia.