27 Dec Polycystic Ovary Syndrome Linked To Multiple Skin Findings
MedicalResearch.com Interview with:
Kanade Shinkai, MD PhD
Associate Professor of Clinical Dermatology
Director, Residency Program
Endowed Chair in Dermatology Medical Student Education
UCSF Department of Dermatology
San Francisco, CA 94115
Medical Research: What is the background for this study? What are the main findings?
Dr. Shinkai: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder in the United States that has important skin manifestations including acne, hair loss, hirsutism, and acanthosis nigricans. We performed a retrospective cross-sectional study of women referred to a multidisciplinary PCOS clinic at UCSF to determine whether skin findings and systemic associations differ between women who meet diagnostic criteria for PCOS versus those suspected of having PCOS but do not meet diagnostic criteria. We found that women with PCOS commonly have skin findings, however, present across a broad spectrum of cutaneous manifestations.
Comparing the skin findings in women who meet diagnostic criteria for PCOS with women who are suspected of having PCOS suggests that it can be very difficult to distinguish a patient with PCOS based on skin findings alone. Hirsutism and acanthosis nigricans are the most helpful findings to suggest PCOS and require a comprehensive skin examination to diagnose; acne and androgenic alopecia are common findings but do not differentiate. The finding of hirsutism and acanthosis were associated with important systemic abnormalities including elevated free testosterone levels, insulin resistance, obesity, and dyslipidemia. This is the first study to perform systematic comprehensive skin exams on women with PCOS and link the skin findings to key systemic associations that have significant implications for the treatment and prognosis of women with the disease.
Medical Research: What should clinicians and patients take away from your report?
Dr. Shinkai: The diagnosis of PCOS requires full physical exam and testing, including comprehensive skin exam, labs, and transvaginal ultrasound to assess the ovaries. Hirsutism and acanthosis nigricans were the most important skin findings specific for PCOS and were associated with important metabolic abnormalities. The findings of hirsutism and acanthosis nigricans in PCOS patients should prompt further diagnostic evaluation or referral for key associated systemic abnormalities.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Shinkai: There is emerging evidence that subtypes of PCOS exist. Whether women within different PCOS subtypes have significant differences in their skin manifestations is unknown. Importantly, whether a diagnosis of each PCOS subtype suggests different systemic associations or distinct long-term prognoses will be key information to determine in the future. Best treatments – especially for the cutaneous manifestations – of PCOS will hopefully be better defined through ongoing research.
Kanade Shinkai, MD PhD (2015). Cutaneous Findings and Systemic Associations in Women With Polycystic Ovary Syndrome