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Journal of the American Academy of Dermatology
Volume 80, n° 6
pages 1497-1506 (juin 2019)
Doi : 10.1016/j.jaad.2018.08.062
accepted : 22 August 2018
Continuing Medical Education

Androgens in women : Androgen-mediated skin disease and patient evaluation

Amanda Bienenfeld, BA a, Sarah Azarchi, BS a, Kristen Lo Sicco, MD b, Shari Marchbein, MD b, Jerry Shapiro, MD b, Arielle R. Nagler, MD b,
a New York University School of Medicine, New York University School of Medicine, New York, New York 
b The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York 

Correspondence to: Arielle R. Nagler, MD, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 E 38th St, 12th Fl, New York, NY 10016.Ronald O. Perelman Department of DermatologyNew York University School of Medicine240 E 38th St, 12th FlNew YorkNY10016

Androgens are produced throughout the body in steroid-producing organs, such as the adrenal glands and ovaries, and in other tissues, like the skin. Several androgens are found normally in women, including dehydroepiandrosterone, dehydroepiandrosterone-sulfate, testosterone, dihydrotestosterone, and androstenedione. These androgens are essential in the development of several common cutaneous conditions in women, including acne, hirsutism, and female pattern hair loss (FPHL)—androgen-mediated cutaneous disorders (AMCDs). However, the role of androgens in the pathophysiology of these diseases is complicated and incompletely understood. In the first article in this Continuing Medical Education series, we discuss the role of the skin in androgen production and the impact of androgens on the skin in women. Specifically, we review the necessary but insufficient role that androgens play in the development of acne, hirsutism, and FPHL in women. Dermatologists face the challenge of differentiating physiologic from pathologic presentations of AMCDs in women. There are currently no dermatology guidelines outlining the indications for endocrinologic evaluation in women presenting with acne, hirsutism, or FPHL. We review the available evidence regarding when to consider an endocrinologic workup in women presenting with AMCDs, including the appropriate type and timing of testing.

The full text of this article is available in PDF format.

Key words : acne, androgenetic alopecia, androgen receptor, androgens, combined oral contraceptive, congenital adrenal hyperplasia, dutasteride, female pattern hair loss, finasteride, flutamide, hirsutism, polycystic ovary syndrome, spironolactone

 Funding sources: None.
 Dr Shapiro has reported the following financial relationship with commercial interests: Aclaris Therapeutics Inc, Advisory Board, Honoraria; Applied Biology, Consultant, Honoraria; Bioniz Therapeutics, Advisory Board, Fees; Johnson & Johnson Consumer Products Company, Consultant, Honoraria; L'Oréal France, Consultant, Honoraria; Self RepliCel Life Sciences Founder, Stock; Samumed, LLC, Advisory Board, Honoraria; Allergan, Inc, Advisory Board, Honoraria; Bayer Consumer Healthcare Pharmaceuticals, Consultant, No Compensation Received; Cassiopea Spa, Advisory Board, No Compensation Received; Incyte Corporation, Consultant, No Compensation Received; RegenLab, Investigator, Grants/Research Funding,, Advisory Board, Stock; and Pfizer, Consultant; Honoraria. All other authors involved with this journal-based CME activity have reported no relevant financial relationships with commercial interest.
 Date of release: June 2019
 Expiration date: June 2022

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