Preview

Meditsinskiy sovet = Medical Council

Advanced search

The efficacy of systemic treatment of androgen-dependent dermopathy in women of reproductive age

https://doi.org/10.21518/2079-701X-2015-9-42-48

Abstract

Due to the associated serious endocrine and metabolic disorders, hyperandrogenic conditions result in skin lesions and deterioration of the quality of life. The present study aimed to evaluate androgen-dependent dermopathy in patients with various clinical status and determine the effectiveness of therapeutic interventions. The study included 82 patients with ADP who underwent a comprehensive examination with the participation of a dermatologist. The patients underwent general and gynecological examination; dermatologist's examination using ultrasound; skin microtopography; blood tests for the level of peptide and steroid hormones; biochemical blood test to evaluate carbohydrate and fat metabolism. Differentiated treatment was assigned based on the data obtained from the survey: patients with irregular menstrual cycle received COCs containing drospirenone (all women were in need of contraception); for overweight or obese women, the therapy was complemented with metformin; patients with regular ovulatory cycles received flutamide. The treatment demonstrated high efficacy against androgen-dependent dermopathy and safety for the metabolic status.

About the Authors

I. V. Kuznetsova
First Moscow State Medical University named after I.M. Sechenov
Russian Federation


K. R. Nabiyeva
First Moscow State Medical University named after I.M. Sechenov
Russian Federation


T. I. Romanstova
First Moscow State Medical University named after I.M. Sechenov
Russian Federation


T. S. Kuzmina
multidisciplinary treatment and diagnostic center GMS Clinic, Moscow
Russian Federation


References

1. Schaefer I, Rustenbach SJ, Zimmer L et al. Prevalence of skin diseases in a cohort of 48,665 employees in Germany. Dermatology 2008; 217(2):169-172.

2. Stankiewicz M, Norman R. Diagnosis and management of polycystic ovary syndrome: a practical guide. Drugs 2006; 66:903-912.

3. Rosenfield RL. Clinical practice. Hirsutism. N Engl J Med 2005; 353: 2578-2588.

4. Hahn S, Janssen OE, Tan S, Pleger K. Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome. Eur J Endocrinol 2005; 153:853-860.

5. Halvorsen JA, Dalgard F, Thoresen M. Is the association between acne and mental distress influenced by diet? Results from a crosssec-tional population study among 3775 late adolescents in Oslo, Norway. BMC Public Health 2009; 9: 340.

6. Himelein MJ, Thatcher SS. Polycystic ovary syndrome and mental health: A review. Obstet Gynecol Surv 2006; 61(11): 723-732.

7. Ching HL, Burke V, Stuckey BGA. Quality of Life and Psychological Morbidity in Women with Polycystic Ovary Syndrome: Body Mass Index, Age and the Provision of Patient Information Are Significant Modifiers. Clin Endocrinol 2007; 66(3): 373-379.

8. Batukan C, Muderris II, Ozcelik B, Oztruk A. Comparison of two oral contraceptives containing either drospirenone or cyproterone acetate in the treatment of hirsutism. Gynecol Endocrinol 2007; 23:38-44.

9. Moghetti T, Toscano V. Treatment of hirsutism and acne in hyperandrogenism. Best Pract Res Clin Endocrinol Metab 2006; 20:221-234.

10. Harwood K, Vuguin P, Dumartino-Nardi J. Current approaches to the diagnosis and treatment of polycystic ovarian syndrome in youth. Horm Res 2007; 68:209-217.

11. Setji TL, Brown AJ. Polycystic ovary syndrome: diagnosis and treatment. Am J Med 2007; 120:128-132.

12. Homburg R. Polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2008; 22(2): 261-274.

13. Bhathena RK. Therapeutic options in the poly-cystic ovary syndrome. J Obstet Gynaecol 2007; 27:123-129.

14. Fauser BC, Tarlatzis BC, Rebar RW, et al. Consensus on women's health aspects of poly-cystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012; 97(1): 28-38.

15. Legro RS, Arslanian SA, Ehrmann DA, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2013; 98(12): 4565-4592.

16. Lopez LM, Grimes DA, Schulz KF. Steroidal contraceptives: effect on carbohydrate metabolism in women without diabetes mellitus. Cochrane Database Syst Rev 2012; 18(4):CD006133.

17. Cagnacci A, Ferrari S, Tirelli A, Zanin R, Volpe A. Insulin sensitivity and lipid metabolism with oral contraceptives containing chlormadinone acetate or desogestrel: a randomized trial. Contraception. 2009; 79:111-116.

18. Sitruk-Ware R, Nath A. Characteristics and metabolic effects of estrogen and progestins contained in oral contraceptive pills. Best Pract Res Clin Endocrinol Metab 2013; 27(1):13-24.

19. Nader S, Aamanti-Kandarakis E. Polycystic ovary syndrome, oral contraceptives and metabolic issues: new perspectives and a unifying hypothesis Hum Reprod 2007; 22(2):317-322.

20. Martin KA, Chang RJ, Ehrmann DA, et а1 Evaluation and treatment of hirsutism in pre-menopausal women: an Endocrine Society Clinical Practice Guideline. J Clin Endocr Metab 2008; 93(4): 1105-1120.

21. Haider A, Shaw JC. Treatment of acne vulgaris. JAMA. 2004; 292(6):726-735.

22. Arowojolu AO, Gallo MF, Lopez LM, Grimes DA. Combined oral contraceptive pills for treatment of acne. Cochrane Database Syst Rev. 2012; 7:CD004425.

23. Gallo MF, Lopez LM, Grimes DA, et al. Cochrane Database Syst Rev 2014; 29(1):CD003987.

24. Skouby SO, Endrikat J, Dusterberg B, et al. A 1-year randomized study to evaluate the effects of a dose reduction in oral contraceptives on lipids and carbohydrate metabolism: 20 microg ethinyl estradiol combined with 100 microg levonorgestrel. Contraception. 2005;71:111-117.


Review

For citations:


Kuznetsova IV, Nabiyeva KR, Romanstova TI, Kuzmina TS. The efficacy of systemic treatment of androgen-dependent dermopathy in women of reproductive age. Meditsinskiy sovet = Medical Council. 2015;(9):42-48. (In Russ.) https://doi.org/10.21518/2079-701X-2015-9-42-48

Views: 626


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)