ʻO Hirsutism kahi maʻi e hoʻopili i nā wahine wale nō, ʻike ʻia e ka hoʻonui ʻana o ka lauoho o ka ʻumiʻumi, kino ... kahi kumu o ka ʻehaʻeha ʻana i ka wahine no ka wahine i hoʻopilikia ʻia.

Ka wehewehe o ka hirsutism

ʻO kēia ka hoʻonui nui ʻana o ka ulu ʻana o ka lauoho i nā wahi kāne (ʻumiʻumi, kino, hoʻi, a pēlā aku) mai ka wā ʻōpio a i ʻole i ka wahine makua.

Hirsutism a i ʻole lauoho lauoho nui?

Hoʻomaopopo mākou i ka hirsutism mai ka hoʻonui ʻana i ka ulu lauoho maʻamau (nā lima, nā wāwae, a me nā mea ʻē aʻe) i kapa ʻia ʻo hypertrichosis. No laila pili wale ka lauoho i ka hypertrichosis i nā wahi maʻamau i nā wahine, akā ʻoi aku ka lōʻihi o ka lauoho, mānoanoa a mānoanoa ma mua o ka maʻamau. 

ʻAʻole like me hirsutism, aia pinepine kēia hyperpilosity i ka wā kamaliʻi a pili i nā kāne ʻelua. ʻOhana pinepine ka Hypertrichosis a he mea maʻamau ia a puni ka ipu Mediterranean a me nā brown. No laila ʻaʻole maikaʻi nā mālama Hormonal a hāʻawi pinepine ʻia ka wehe ʻana i ka lauoho laser.

ʻO Hirsutism ke ʻano o ka hopena o nā kāne kāne i ka meaola wahine. ʻEkolu ʻano nui o nā hormona e hiki ke hoʻopili i ka ulu ʻana o ka lauoho i nā wahi kāne i nā wahine.

Nā homone kāne mai ka ovary (testosterone a me Delta 4 Androstenedione):

ʻO kā lākou hoʻonui ʻana ke aniani o kahi tumo ovarian e hūnā ana i kēia mau homone kāne a i ʻoi aku paha o nā microcstist ma nā ovaries e hūnā nei i kēia mau homona (micropolycystic ovary syndrome). I ka hanana o kahi kiʻekiʻe o ka serum testosterone a i ʻole Delta 4-androstenedione pae, kuhikuhi ke kauka i kahi ultrasound endovaginal e nānā no kēia mau pathologies ʻelua (micropolycystic ovaries a i ʻole ovarian tumor).

ʻO nā homoni kāne kāne mai ke kaha adrenal

ʻO SDHA kēia no De Hydroepi Androsterone Sulfate i hūnā ʻia e kahi tumo adrenal a ʻoi aku ka nui o ka hana adrenal hyperandrogenism e ka hoʻonui kūpono ʻana i ka huna o 17 hydroxyprogesterone (17-OHP) a laila e koi ana i kahi hoʻāʻo hoʻāla me Synacthène® e hōʻoia i ka ʻike. ʻOi aku ka liʻiliʻi, no ka mea ua ʻōnaehana ʻia ia i ka hānau ʻana e kahi hāpana koko mai ka kuʻekuʻe ma ka lā 3 o ke ola ma ke ana ʻana i ka pae o 17 hydroxyprogesterone (17-OHP) i loko o ke koko, hiki i ka anomaly ke hānau: he hana hānau ia adrenal hyperplasia e 21-hydroxylase nele i pili i ka hoʻololi o kāna ʻāpana ma chromosome 6.

ʻO Cortisol

ʻO ka piʻi ʻana o ka cortisol i loko o ke koko (Cushing's Syndrome) ma muli paha o ka hoʻohana lōʻihi ʻana i nā corticosteroids, kahi ʻōpū huna cortisol huna, a i ʻole kahi tumo huna ACTH (he hormone e huna ana i ka cortisol mai ka ʻalani adrenal).

Kū pinepine ka tumor i ka wahine makua, ʻoiai ʻo ka hirsutism i ka wā ʻōpio ma muli o ka ovarian hana a hyperandrogenism adrenal paha.

Me nā lāʻau hormonal maʻamau a me ka ultrasound ovarian maʻamau, kapa ʻia ia ʻo idiopathic hirsutism.

No laila, i ka hoʻomaʻamaʻa, i ke alo o hirsutism, noi ke kauka no kahi mahele koko o testosterone, Delta 4-androstenedione, SDHA a me 17-hydroxyprogesterone (me ka hoʻāʻo Synacthène® inā he kiʻekiʻe kiʻekiʻe ia), ʻo Cortisoluria inā e manaʻo ʻia ʻo Cushing a me kahi ultrasound ultrasound.

Pono e noi i nā dosages me ka lawe ʻole ʻana i ka cortisone, me ka ʻole o ka pale hormonal no ʻekolu mau mahina. Pono lākou e hana i ke kakahiaka ma kahi o 8 am a ma kekahi o nā lā ʻeono mua o ke pōʻaiapuni (ʻaʻole pono e noi ʻia iā lākou i loko o ʻekolu mau makahiki o ke ʻano ʻōpio no ka pili ʻole o lākou).

ʻO nā lauoho paʻa i ka maka, ka ʻāʻī, hoʻi ... i nā wahine.

Nānā ke kauka no nā ʻōuli ʻē aʻe e pili ana i ka hyperandrogenism (hoʻonui i nā homone kāne): hyperseborrhea, huehue, androgenetic alopecia a ʻōhule paha, nā maʻi menstruation ... a i ʻole ka virilization (clitoral hypertrophy, hohonu a me ka leo kani). Hōʻike kēia mau hōʻailona i ka hoʻonui ʻia o nā pae hormonone i ke koko a no laila ʻaʻole e hoʻopaʻapaʻa no ka idiopathic hirsutism.

ʻO ke kuʻi koke ʻana o kēia mau hōʻailona ma kahi kikoʻī e kuhikuhi ana i ka tumo ʻoiai ʻoi aku ka makemake o ka ʻōpio hana i ka ovarian a i ʻole hyperandrogenism adrenal, a i ʻole idiopathic hirsutism inā he maʻamau nā hoʻokolokolo.

Nā mea pilikino

ʻO nā kumu pilikia no ka hirsutism i loko o nā wahine:

• ke lawe nei i ka cortisone no kekahi mau mahina (Cushing's syndrome)
• momona: hiki ke hōʻike i kahi pilikia cortisol a i ʻole ʻāpana o kahi polycystic ovary syndrome. Akā ʻike pū mākou he ʻano maʻalahi ka momona e paipai i ka metabolization o nā kāne kāne.
• moʻolelo ʻohana o ka hirsutism

Evolution a me nā pilikia i hiki

Pili ʻo Hirsutism i kahi tumo e hōʻike i ka poʻe i nā pōpilikia e pili ana i ka tumo iho, keu hoʻi inā he malignant (ka makaʻu o nā metastases, a pēlā aku.)

ʻO Hirsutism, inā he tumoral a i ʻole hana, me ka hoʻohui ʻana i kāna mea hoʻonani estetika, paʻakikī pinepine ʻia e ka huehue, follikulitis, ʻōhule i nā wahine…

Hoʻokumu ʻia ka mālama ʻana i ka hirsutism ma ka mālama ʻana i ke kumu a me ka hui pū ʻana o ka lawe ʻana i nā anti-androgens a me ka wehe ʻana i ka lauoho a i ʻole nā ​​hana depilation.

Lapaʻau o ke kumu

Ke hemo ʻana o kahi tumo ovarian a adrenal paha, tumo hūnā ʻo ACTH (aia pinepine i loko o ka akemāmā) ... inā pono.

Hoʻohui o kahi depilation a i ʻole depilation ʻenehana a me kahi anti-androgen

Pono e hui pū ʻia nā hana hoʻohemo lauoho a i ʻole depilation me ka anti-androgen hormonal lapaʻau e kaupalena ai i ka makaʻu o ka ulu lauoho lauoho

Lawe ka lauoho a me ka depilation

Hiki ke hoʻohana ʻia i nā ʻano hana he nui e like me ke kala ʻana i ka lauoho, ka ʻumi ʻana, nā kalima depilatory, ka wili ʻana a i ʻole ka hemo ʻana o ka lauoho uila i ke keʻena dermatologist ʻeha a luhi hoʻi.

Aia kekahi kalima e pili ana i ka eflornithine, kahi mole mole antiparasitic, i noi ʻia ma kahi kūloko, ālai i ka ornithine decarboxylase, kahi enzyme e pili ana i ka hana ʻana o ka lauoho e ka lauoho lauoho. ʻO Vaniqa® kēia, noi ʻia i ʻelua mau manawa i ka lā, hoʻēmi i ka ulu ʻana o ka lauoho.

Hōʻike ʻia ka hemo ʻana o ka lauoho laser i nā hihia o ka hirsutism nui. Hoʻohui ʻia me ka anti-androgen therapy e pale ai i ka hoʻi hou ʻana.

ʻAi i nā androgens

ʻO ka huaʻōlelo anti-androgen ʻo ia ka mea o ka moleola e kāpae i ka hoʻopaʻa ʻana o testosterone (e kikoʻī ʻo 5-dihydrotestosteron) i ka mea loaʻa iā ia. Ma muli o ka loaʻa ʻole o ka testosterone i kāna mau pane i ka lauoho, ʻaʻole hiki iā ia ke hana hou i kahi hopena stimulate.

Hoʻohana ʻia ʻelua i ka hana o kēia manawa:

• uku hou ʻia ʻo cyproterone acetate (Androcur®) ma Palani no ka hōʻailona o ka hirsutism. Ma waho aʻe o kāna hana anti-androgen receptor block, hana pū kekahi me kahi antigonadotropic hopena (hoʻemi ia i ka hana o androgens e ka hōʻemi ʻana i ka stimition pituitary) a me ka pāpā ʻana o ka 5-dihydrotestolone / receptor complex ma ka pae o ka androgen binding protein. .

He progestogen ia e pono ai e hui pinepine ʻia me ka estrogen e mimic i ke kalapona hormonal maoli o nā wahine: kuhikuhi pinepine ke kauka i kahi papa o Androcur® 50 mg / lā i hui pū ʻia me ka estrogen maoli i ka papa, gel a i ʻole patch, iwakālua mau lā mai iwakāluakūmāwalu.

ʻIke wale ʻia ka hoʻomaikaʻi ʻana i ka hirsutism ma hope o 6 mau mahina o ka mālama ʻana.

• spironolactone (Aldactone®), he diuretic, hiki ke hāʻawi ʻia i ka lepili-ʻole. Ma waho o ka hopena anti-androgenic receptor i ka hopena, pale ia i ka synthesist testosterone. Kauoha ke kauka i ʻelua papa i kēlā me kēia lā o 50 a 75 mg paha e hoʻokō i ka mahele lāʻau o 100 a 150 mg / lā i kēlā me kēia lā, i ka hui pū ʻana, he ʻumikūmālima mau lā i kēlā me kēia mahina, me kahi progestogen non-androgenic e hōʻalo ai i nā maʻi pōʻaiapuni. E like me ka cyproterone acetate, hoʻomaka ka hopena e ʻike ʻia ma hope o 6 mau mahina o ka mālama ʻana, i kekahi manawa i hoʻokahi makahiki.