Cutaneous conditions 'reliable markers' for PCOS

Issue: April 2016

Hirsutism and acanthosis nigricans were identified as markers for polycystic ovary syndrome, according to research presented at the American Academy of Dermatology Annual Meeting.

When these conditions are present, patients should be evaluated for metabolic comorbidities, Timothy H. Schmidt, MD, PhD, University of California, San Francisco, and colleagues said in their poster presentation.

"Understanding the associations among cutaneous findings, systemic abnormalities and fulfillment of the diagnostic criteria in women suspected of having PCOS is incomplete," they wrote.

The researchers conducted a retrospective cross-sectional study of women who were referred to the University of California, San Francisco, Polycystic Ovary Syndrome Multidisciplinary Clinic between May 2006 and October 2012. Their final cohort consisted of 401 referred women suspected to have PCOS.

Schmidt and colleagues assessed patient data from laboratory testing, comprehensive skin examinations and transvaginal ultrasonography.

Results showed that women who met PCOS diagnostic criteria had higher rates of hirsutism (53.3% vs. 31.2%, P = .005), acanthosis nigricans (36.9% vs. 20%, P = .03) and acne (61.2% vs. 40.4%, P = .004) when compared with women who did not meet the criteria. In addition, women who met PCOS diagnostic criteria had higher testosterone levels (40.7% vs. 4.3%, P < .001) when compared with women who did not meet the criteria.

Presence of hirsutism or acanthosis nigricans was associated with various metabolic abnormalities, including dyslipidemia, elevated BMI and insulin resistance in women with PCOS.

Women who met PCOS diagnostic criteria presented with higher rates of axillary acanthosis nigricans and more severe truncal hirsutism that women who did not. Schmidt and colleagues reported that acne prevalence was higher in women with PCOS, but it was not a reliable marker.

"Hirsutism and [acanthosis nigricans] are the most reliable cutaneous markers of PCOS and require a comprehensive skin examination to diagnose," they wrote. "When present, hirsutism and [acanthosis nigricans] should raise clinical concern that warrants further diagnostic evaluation for metabolic comorbidities that may lead to long-term complications." – by Chelsea Frajerman Pardes

Disclosures: Healio Internal Medicine could not confirm relevant financial disclosures at the time of publication.

Reference:

Schmidt TH, et al. Poster 2754. Presented at: American Academy of Dermatology 74th Annual Meeting; March 4-8, 2016; Washington, D.C.