Abstract
Background: Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine disorder affecting 5%-10% of women worldwide. PCOS patients usually present with cutaneous manifestations of hyperandrogenism, such as acne, hirsutism, and androgenic alopecia.Objective: To estimate the prevalence of dermatological manifestations and their association with hormonal changes in PCOS patients. In addition, this study aimed to estimate the prevalence of comorbidities associated with PCOS and to demonstrate the referral pattern among Dermatology, Gynecology, and Primary Health Care (PHC).Methods: This is a cross-sectional study conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. All PCOS patients who attended KAMC from 2016 to 2021 were included. Data were collected through a retrospective chart review of the electronic medical record system (BestCare) and by utilizing a structured data collection sheet.Results: A total of 447 female patients were diagnosed with PCOS with a median age of 29 years and a median BMI of 28.76 kg/m2.The prevalence of cutaneous manifestations among patients was 68%. Hirsutism (47.3%), acne vulgaris (40.6%), and androgenic alopecia (20.3%) were the most common manifestations. The most common hormonal abnormalities were raised luteinizing hormone (LH) levels in 220 (49.1%) patients and raised LH/follicle-stimulating hormone (FSH) ratio in 159 (35.5%) patients. FSH, LH/FSH ratio, and age were significant predictors for acne vulgaris (P-value=0.01, 0.04, and 0.01, respectively). Obesity (44.20%), infertility (25.70%), and dyslipidemia (17%) were the most common comorbidities in our sample. Most patients' first visits and follow-ups were in PHC. Conclusion: The prevalence of cutaneous manifestations among PCOS patients is relatively high and plays a significant role in making the diagnosis. Therefore, physicians across multiple specialties need to be more aware of the full spectrum of PCOS presentations to alleviate it from its under-diagnosed status.
Highlights
Polycystic ovary syndrome (PCOS) is a highly prevalent heterogeneous endocrine disorder that affects 5%10% of reproductive-aged women worldwide [1]
A total of 447 female patients were diagnosed with PCOS with a median age of 29 years and a median body mass index (BMI) of 28.76 kg/m2.The prevalence of cutaneous manifestations among patients was 68%
The referral pattern and follow-up visits with Primary Health Care (PHC), Gynecology, and Dermatology have shown the same order with the following percentages (60.3%), (9.2%), and (8.5%), respectively
Summary
Polycystic ovary syndrome (PCOS) is a highly prevalent heterogeneous endocrine disorder that affects 5%10% of reproductive-aged women worldwide [1]. The hallmark of PCOS is disrupted hypothalamic-pituitary-ovarian axis that leads to high pulse frequency gonadotropin-releasing hormone (GnRH) secretion, which favors luteinizing hormone (LH) secretion over follicle-stimulating hormone (FSH) secretion. The subsequently high LH/FSH ratio stimulates the ovarian theca cells to synthesize excess androgen causing hyperandrogenemia and clinical symptoms of hyperandrogenism [3]. The endocrine profile of women with PCOS includes high levels of adrenal and ovarian androgen and estrogen, abnormalities in gonadotropin (LH and FSH) levels, low levels of serum sex hormone-binding globulin (SHBG), and sometimes elevated serum insulin [4]. Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine disorder affecting 5%-10% of women worldwide. PCOS patients usually present with cutaneous manifestations of hyperandrogenism, such as acne, hirsutism, and androgenic alopecia
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