Axillary Hair Research Articles

Premature Thelarche: An Updated Review.

Premature thelarche is the most common pubertal disorder in girls. The condition should be differentiated from central precocious puberty which may result in early epiphyseal fusion and reduced adult height, necessitating treatment. The purpose of this article is to familiarize physicians with the clinical manifestations of premature thelarche and laboratory tests that may help distinguish premature thelarche from central precocious puberty. A search was conducted in September 2022 in PubMed Clinical Queries using the key term "Premature thelarche". The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used to compile the present article. Premature thelarche denotes isolated breast development before the age of 8 years in girls who do not manifest other signs of pubertal development. The condition is especially prevalent during the first two years of life. The majority of cases of premature thelarche are idiopathic. The condition may result from an unsuppressed hypothalamic-pituitary-gonadal axis in the early years of life, an "overactivation" of the hypothalamic-pituitary axis in early childhood secondary to altered sensitivity to steroids of the hypothalamic receptors controlling sexual maturation, increased circulating free estradiol, increased sensitivity of breast tissue to estrogens, and exposure to exogenous estrogens. The cardinal feature of premature thelarche is breast development which occurs without additional signs of pubertal development in girls under 8 years of age. The enlargement may involve only one breast, both breasts asymmetrically, or both breasts symmetrically. The breast size may fluctuate cyclically. The enlarged breast tissue may be transiently tender. There should be no significant changes in the nipples or areolae and no pubic or axillary hair. The vulva, labia majora, labia minora, and vagina remain prepubertal. Affected girls have a childlike body habitus and do not have mature contours. They are of average height and weight. Growth and osseous maturation, the onset of puberty and menarche, and the pattern of adolescent sexual development remain normal. Most cases of premature thelarche can be diagnosed on clinical grounds. Laboratory tests are seldom indicated. No single test can reliably differentiate premature thelarche from precocious puberty. Premature thelarche is benign, and no therapy is necessary apart from parental reassurance. As enlargement of breasts may be the first sign of central precocious puberty, a prolonged follow- up period every 3 to 6 months with close monitoring of other pubertal events and linear growth is indicated in all instances.

8380 Pituitary Stalk Interruption Syndrome, A Rare Cause of Panhypopituitarism

Abstract Disclosure: F. Abdulkarim: None. E. Alshdifat: None. P. Henriquez Feliz: None. J. Vargas-Jerez: None. T. Zahra: None. Pituitary Stalk Interruption Syndrome, A Rare Cause of Panhypopituitarism Faridat Abdulkarim, MD. Esra’a Alshdifat, MD. Pamela Henriquez Feliz, MD. Julia Vargas- Jerez, MD. and Tasneem Zahra, MD. Introduction: Pituitary stalk interruption syndrome (PSIS) is a rare congenital pituitary anatomical abnormality with reported incidence of 0.5 per 100,000 live births. It is characterized by the triad of thin or interrupted pituitary stalk, absent or ectopic posterior lobe and hypoplastic or aplastic anterior lobe seen on MRI. The anterior pituitary function is usually impaired however the posterior pituitary is usually intact and normal. We report a case of a Now 34-year-old Female who presented to the endocrine clinic with underdeveloped sexual characteristics. MRI done was consistent with PSIS. This is the second case of PSIS we report from our Institution. Case Presentation: A Now 34-year -old Hispanic American Female presented to our endocrine clinic with underdeveloped secondary sexual characteristics. She had panhypopituitarism, including Growth hormone deficiency and was treated with growth hormone from early childhood until age 13-14 years. She re-presented to our clinic at the age of 28 years after being lost to follow up for many years. On physical examination, she was 175cm tall, weighed 89.4kg and BMI 29.1kg/m2Patient has pre-pubertal breast, tanner stage 1, no axillary hair, small external genitalia with scanty pubic hair. Hormonal analysis revealed Estradiol <5 pg/mL (low), FSH 0.4 IU/L (low), LH <0.3 IU/L (low), Progesterone 0.1ng/mL (Low), Testosterone <2.5 ng/dL (8.4- 48.1ng/dl) Prolactin 22.3ng/mL (3.4-24.1 ng/ml), TSH 0.88uIU/mL (0.27-4.20), Free T4 0.5ng/dl (0.9-1.8) , ACTH 7.7pg/mL (7.2-63.3), Baseline AM Cortisol 0.7ug/dL (6.0-18.4) and 5.5 ug/dL after Cosyntropin test, IGF-1 17ng/mL (83-280). Urinalysis revealed normal specific gravity. Chromosome analysis with Normal Karyotype 46XX. Pelvic US revealed Markedly diminutive uterus and ovaries. MRI of the pituitary was highly suggestive of PSIS. She is currently being treated with levothyroxine and hydrocortisone Conclusion: PSIS is a rare congenital abnormality. Fortunately has good prognosis, however if left undiagnosed/untreated has high mortality mainly from Adrenal insufficiency and Myxedema coma. The patient discussed above, has underdeveloped sexual characteristics and primary amenorrheaLaboratory finding consistent with Panhypopituitarism with Normal prolactin which is the case in most patient with PSIS. Imaging revealed atrophic uterus and ovaries, and MRI revealed Findings which are highly suggestive of PSISShe previously had problems with outpatient clinic visits and medication compliance. However, she is currently compliant with hormonal replacement therapy which is the mainstay of treatment. Presentation: 6/3/2024

6597 An Unusual Case of Klinefelter Syndrome with Both Primary and Superimposed Secondary Hypogonadism

Abstract Disclosure: A. Krueger: None. E. Pelley: None. Introduction: Klinefelter syndrome (KS) (47, XXY) is a sex-chromosome disorder that is a common cause of infertility and hypogonadism in men. Clinical phenotype includes tall stature, delayed or incomplete puberty, small testes (<4ml), gynecomastia, and oligo or azoospermia. The extra X chromosome leads to fibrosis and hyalinization of seminiferous tubules resulting in impaired sperm production. Leydig cells also function abnormally and fail to stimulate with LH. Common biochemical evaluation results in low serum testosterone, elevated FSH and LH concentrations, and azoospermia. Case Report: 37-year-old male presented with long standing history of low libido and a perception that he had never fully progressed through puberty. Physical exam was notable for a height of 6’ 4”, obesity, fine pubic and axillary hair, and testes <4mL bilaterally. Initial biochemical work up revealed low serum total testosterone 43 (ref 300-1080 ng/dL), low free testosterone 8.1 (ref 47-244 pg/mL), inappropriately normal LH 10.8 (ref 0.6-12.1 mlU/mL), and elevated FSH 28.3 (ref 1.0-12.0 mlU/mL). Patient was referred to Endocrinology. Labs were repeated with consistent results in addition to chromosome analysis which confirmed diagnosis of Klinefelter syndrome with (47, XXY) karyotype. Due to inappropriately normal LH and mixed picture of primary and superimposed secondary hypogonadism, an MRI of the pituitary was obtained and revealed an 8mm x7mm x 14mm pituitary macroadenoma. Evaluation for pituitary hypersecretion and other deficiencies was unremarkable. Conclusion: Data from the Danish National registry shows that only 25% of Klinefelter patients are correctly diagnosed. Klinefelter syndrome should be considered in the differential for the evaluation of hypogonadism and infertility. Diagnosis can be made by karyotyping. The degree of impaired spermatogenesis and testosterone production in Klinefelter syndrome can be variable. Biochemical evaluation should be interpreted in conjunction with clinical context. Patients with known causes of primary hypogonadism who demonstrate an inappropriate gonadotropin response require evaluation for causes of secondary hypogonadism. In this case, the inappropriately normal LH was the sole clue leading to the identification of his pituitary macroadenoma. Presentation: 6/1/2024

Pattern of physical growth and pubertal changes in adolescent girls with Systemic Lupus Erythematosus

ABSTRACT Aims: To study the pattern of physical growth and pubertal changes in adolescent girls with Systemic Lupus Erythematosus (SLE). Methods and Material: Weight, height, BMI, waist and hip circumference among 50 adolescent SLE girls (aged 8–17 years) were cross-sectionally studied using standardized techniques and instruments. Breast development stage, presence or absence of pubic and axillary hair and age of attainment of menarche were also noted. Results: With the advancement of age, weight and height of SLE girls increased but they were lighter and shorter compared to normal Indian peers. 18.4% of study girls were short-statured while only one participant was underweight. As per mid-parental height, 34.3% were predicted to have shorter final heights. BMI demonstrated an inconsistent trend with 12.3% and 9.2% being obese and overweight, respectively. Interestingly, 10.7% of SLE girls were at risk of metabolic syndrome (waist circumference >70th centile). About 50% of study girls had attained menarche (mean age: 13.04 ± 1.38 years). Appearance of pubic and axillary hair occurred around 1 year later than attainment of menarche. 33.80% of study subjects were in prepubertal stage of breast development and rest 66.20% were in advanced stages of breast development. SLE girls who had younger age at diagnosis and longer duration of therapy had significant delay in breast development and attainment of menarche. Conclusions: SLE girls show delayed growth and pubertal attainments compared to their normal Indian and Western counterparts. The data presented will provide an understanding of the auxological dynamics and pattern of pubertal changes among adolescent girls with SLE living in north-western India.

Evaluation and comparison of nine growth and development-based measures of pubertal timing

BackgroundPubertal timing is heritable, varies between individuals, and has implications for life-course health. There are many different indicators of pubertal timing, and how they relate to each other is unclear. Our aim was to quantitatively compare nine indicators of pubertal timing.MethodsWe used data from questionnaires and height, weight, and bone measurements from ages 7–17 y in a population-based cohort of 4267 females and 4251 males to compare nine growth and development-based indicators of pubertal timing. We summarise age of each indicator, their phenotypic and genetic correlations, and how they relate to established genetic risk score (GRS) for puberty timing, and phenotypic childhood body composition measures.ResultsWe show that pubic hair in males (mean: 12.6 y) and breasts in females (11.5 y) are early indicators of puberty, and voice breaking (14.2 y) and menarche (12.7 y) are late indicators however, there is substantial variation between individuals in pubertal age. All indicators show evidence of positive phenotypic intercorrelations (e.g., r = 0.49: male genitalia and pubic hair ages), and positive genetic intercorrelations. An age at menarche GRS positively associates with all other pubertal age indicators (e.g., difference in female age at peak height velocity per SD higher GRS: 0.24 y, 95%CI: 0.21 to 0.26), as does an age at voice breaking GRS (e.g., difference in age at male axillary hair: 0.11 y, 0.07 to 0.15). Higher childhood fat mass and lean mass associated with earlier puberty timing.ConclusionsOur findings provide insights into the measurements of the timing of pubertal growth and development and illustrate value of various pubertal timing indicators in life-course research.

An Interesting Case of Cushing Syndrome

An Interesting Case of Cushing Syndrome A 36 year old female presented to dermatology department with Multiple ulcers present in B/L axilla, B/L inframammary fold and B/L gluteal fold (Left > Right) since 3 months. Patient was referred from dermatology department to General Medicine for opinion on puffiness of face and swelling of legs . Patient had history of topical steroid use for itchy lesions in B/L axilla and inframammary folds 4 months back . H/o weight gain present. (6 kg). H/o puffiness of face and striae present over the abdomen. Patient had no known comorbidities previously. On physical examination patient had moon face ,facial plethora + ,Buffalo hump ,Loss of axillary hair, centripetal obesity , Abdominal striae , Sparse pubic hair , Pallor +. Systemic examination was normal. Investigations revealed new onset diabetes , serum cortisol was low (<0.5 mcg/ml) , serum acth was low (1pg/ml) , HB was low (7.9gm/dl) , total count was elevated (15,600) . Patient was diagnosed to have Iatrogenic (Topical steroid induced) Cushing Syndrome with Steroid induced atrophy and ulceration of skin & subcutaneous tissue leading to secondary fungal and bacterial infection , tinea incognito with secondary bacterial infection , iron deficiency anemia and newly detected Type 2 Diabetes mellitus. Patient was appropiately treated with iv antibiotics (Inj Piperacillin Tazobactum 4.5 g iv thrice daily), daily dressing on other supportive measures along with discontinuation of steroids. Patient improved symptomatically after discontinuing topical steroids, the cushingoid features started decreasing. The ulcers also started to heal. The patient was started on Tab. Hydrocortisone 10mg - 0 – 5mg and was referred for Endocrinologist opinion

Study of Sexual Maturation in Children With Juvenile Dermatomyositis

Objective: There is complete absence of sexual maturity data on patients afflicted with juvenile dermatomyositis (JDMS) from the Indian subcontinent. Hence, this study aimed to unfold the effect of this disease on the sexual development of JDMS children. Methods: In the Growth Laboratory/Clinic of the Department of Pediatrics, 60 (25 male and 35 female) sexual maturity-related observations were made on 35 JDMS patients, aged 10–17 years, enrolled from the Pediatric Rheumatology Clinic. Breast development stage and age of onset of menarche were recorded among female patients. In male patients, besides, determining the genitalia development stage, measurement of stretched penile length and testicular volume was done. Appearance of pubic and axillary hair among JDMS patients of both sexes was recorded. Results: Most girls with JDMS (34.28%) were in breast development stage-B2 (mean age 10.91 ± 1.08 years) and 22.86% had attained menarche. However, breast stage B5 was attained at 14.62 ± 1.06 years. JDMS girls reached stage B2 at the same age as their normal healthy counterparts. Onset of menarche was delayed by almost a year in JDMS girls. Age of attainment of genitalia stage G2 in JDMS boys (12 years) was delayed by 6 months as compared to well-off Chandigarh boys (11.5 years), whereas it was advanced by 1.5 years when contrasted with affluent Indian counterparts (13.3 years). Conclusion: Comparable pubertal attainments in JDMS males and somewhat delayed start of menarche in female JDMS patients as compared to their normal counterparts show that disease activity has a smaller effect on the sexual development of JDMS patients from north-western India.

Maternal stress in pregnancy and pubertal timing in girls and boys: a cohort study

To investigate whether maternal stress in pregnancy is associated with pubertal timing in girls and boys and to explore potential mediation by childhood body mass index (BMI) and childhood psychosocial stress. Cohort study. Not applicable. In total, 14,702 girls and boys from the Puberty Cohort, nested within the Danish National Birth Cohort. Maternal stress was obtained from a computer-assisted telephone interview in gestational weeks 30-32 as maternal life stress and emotional distress in pregnancy using questions on the basis of validated screening tools. Maternal life stress and emotional distress in pregnancy were analyzed separately and in an interaction analysis. Pubertal timing was measured half-yearly from age 11 years and throughout pubertal development and assessed as Tanner stages 1-5 (breast and pubic hair development in girls and genital and pubic hair development in boys), menarche in girls, voice break and first ejaculation in boys, and occurrence of acne and axillary hair in both girls and boys. A combined estimate for overall pubertal timing was derived using Huber-White robust variance estimation. Mean differences in age at attaining the pubertal milestones according to prenatal exposure to no (reference), low-, moderate-, or high-maternal stress in pregnancy were estimated using a multivariable censored regression model. Potential mediation by childhood BMI and childhood psychosocial stress was investigated in separate models. After adjustment for potential confounding factors, prenatal exposure to high-maternal life stress (combined estimate: -1.8 months [95% CI, -2.7 to -0.8] and -0.9 months [95% CI, -1.8 to 0.0]), high maternal emotional distress (combined estimate: -1.5 months [95% CI, -2.5 to -0.5] and -1.7 months [95% CI, -2.8 to -0.7]), and both high-maternal life stress and emotional distress (combined estimate: -2.8 months [95% CI, -4.2, to -1.4] and -1.7 months [95% CI, -3.1 to -0.2]) were associated with earlier pubertal timing in girls and boys, respectively. The associations were not mediated by childhood BMI or childhood psychosocial stress. Prenatal exposure to maternal stress in pregnancy was associated with earlier pubertal timing in girls and boys in a dose-dependent manner. The associations were not mediated by childhood BMI or childhood psychosocial stress.

Secondary Adrenal Insufficiency : A Case Report

Introduction: Insufficient pituitary hormone output is referred to as hypopituitarism. Individuals experiencing lethargy, dizziness, orthostatic hypotension, hypoglycemia, nausea, vomiting, or generalized abdominal pain may be diagnosed with acute adrenocorticotropic hormone (ACTH) insufficiency. This report detailed a unique instance of hypopituitarism in a patient who complained of nausea, vomiting, hypotension, hypoglycemia, and overall abdominal pain and soreness. Case presentation: A 65-year-old male presented to the outpatient department with complaints of a cough of 1-day duration on August 9/03/21 associated with 4 to 5 episodes of vomiting and pain in the abdomen, in addition to that whole body darkening, fatigue, and appetite loss of 6 months. weight loss intermittent sweating, and eyebrow and axillary hair loss. SOB with mild activity and also bilateral breast pain but no mass. Discussion: The diagnosis of hypothyroidism and inexplicable fatigue made us believe that there was an adrenal deficiency, which might be treated with cortisol around eight o’clock. Even though the patient with a high stress level the cortisol was immeasurable; so the diagnosis, of adrenal insufficiency, could be made. Other tests including ACTH and Imaging are usually needed to discover the subtype of insufficiency. The follow-up after 1 month showed no signs or symptoms left and a much better condition. Conclusion: When treating individuals who have fatigue that cannot be attributed to anything else, especially when weight loss and muscle weakness are present, adrenal insufficiency should be taken into consideration. A secondary adrenal insufficiency may exist even in the absence of skin pigmentation, which frequently triggers anxieties and ideas about Addison’s disease. If it is not identified promptly, it may potentially result in an adrenal crisis in situations with high-stress levels. Our patient presented with vague and largely mild symptoms related to early secondary adrenal insufficiency. These included nausea and vomiting, as well as fatigue. Laboratory studies indicated new hyponatremia and urine studies showed inappropriately normal urine sodium and osmolality. His morning serum cortisol was low, with borderline low ACTH, consistent with a secondary cause.

Axillary hair removal with simultaneous emission of LP alexandrite 755 nm and LP Nd:YAG 1064 nm: a prospective comparative evaluation of both lasers used individually and in dual mode

ABSTRACT Background Alexandrite laser is more adapted for lighter hair but not for darker skin, while the Nd:YAG laser is more suitable for darker skin but not for lighter hair. Objective To evaluate both laser used as single treatment and in simultaneous emission for axillary hair removal. Method Ten patients (18–40 years old) were selected for this study. The spot size and pulse time were kept constant for all patients, 14 mm and 5 ms, respectively. The fluences were 20 to 28 J/cm2, 16 to 25 J/cm2, and 14–8 J/cm2 to 25–13 J/cm2 for Nd:YAG, alexandrite and the combined alex/YAG, respectively. Three treatment sessions were performed at 6-week interval, and patients were reviewed 4 months after the last session. Results The median number of hairs reduced from 46.00 to 33.00 (p = .022) for alexandrite, from 44.50 to 30.00 (p = .02) for Nd:YAG and from 56.00 to 19.50 (p = .005) for alexandrite-Nd:YAG, equivalent to 46.70%, 27.74% and 70.12% median hair reduction, respectively. Conclusions The simultaneous emission of both 755 nm and 1064 nm Nd:YAG laser is significantly more effective than a single laser treatment. Future studies are needed to confirm the good results of this innovative technique.

Prepubertal exposure to polycyclic aromatic hydrocarbons are associated with early pubertal development onset in boys: A longitudinal study

ObjectiveTo investigate the effects of polycyclic aromatic hydrocarbons(PAHs) on puberty in boys. Methods695 subjects were selected from four primary schools in Chongqing, China. 675 urine samples from these boys were collected four PAH metabolites: 1-hydroxypyrene, 2-hydroxynaphthoic, 2-hydroxyfluorene, and 9-hydroxyphenanthrene. Pubertal development of 695 boys was assessed at follow-up visits starting in December 2015 and occurring every six months thereafter until now, data used in this article ending in June 2021. A total of 12 follow-up visits were performed. Cox proportional hazards regression models were used to analyze the relationship between PAH metabolite concentrations and indicators of pubertal timing. ResultsThe mean age at puberty onset of testicular volume, facial hair, pubic hair, first ejaculation, and axillary hair in boys was 11.66, 12.43, 12.51, 12.72 and 13.70 years, respectively. Cox proportional hazards regression models showed that boys with moderate level of 1-OHPyr exposure was associated with earlier testicular development (hazard ratio [HR] = 1.276, 95% confidence interval [CI]: 1.006–1.619), with moderate level of 2-OHNap were at higher risk of early testicular development (HR = 1.273, 95% CI: 1.002–1.617) and early axillary hair development (HR = 1.355, 95% CI: 1.040–1.764), with moderate level of 2-OHFlu was associated with earlier pubic hair development (HR = 1.256, 95% CI: 1.001–1.577), with high level of 9-OHPhe were at higher risk of early fisrt ejaculation (HR = 1.333, 95% CI: 1.005–1.767) and early facial hair development (HR = 1.393, 95% CI: 1.059–1.831). ConclusionPrepubertal exposure to PAHs may be associated with earlier pubertal development in boys.

Biological age assessment method teenage students

To assess the biological age of adolescents, the special literature offers 9 methods for boys and 14 methods for girls. The aim of the article was to determine the more informative methods for boys and girls. Methods: anthropometry, somatometry, somatoscopy, tonometry, spirometry, dynamometry, Hench and Shtange tests, Ruffier and Robinson indices. The interaction of the results of different methods for the assessment of biological age was analysed using factor analysis (principal components method) for groups of subjects of the same gender and age. Boys aged 14-15 (n=102) and girls aged 12-13 (n=101) were studied. The choice of these age groups was explained by the presence of the most significant individual differences in morpho-functional features in the school students of this age. Results: among the methods for assessment of biological age in adolescent school students proposed in the literature, there is not a single one that would be statistically siginificantly related to the other methods. This applies to both boys and girls. The biological age of adolescents can be reliably determined using a set of three components: an assessment of physical development, the heterochronicity index, and the degree of manifestation of secondary sexual characteristics (for boys with a probability of 90.2%, for girls - 92.1%). The percentage ratio of these components has gender peculiarities. Methods for assessing biological age for scientific purposes and quick assessment for use in the practice of physical education and sports are proposed. The indicators in quick assessment technique include body length and the degree of development of the axillary hair. The reliability of the quick assessment technique is 81.4% for boys and 83.2% for girls. Conclusion: the development of adequate physical activity for adolescents of different biological ages will help to improve the physical health of the younger generation.

Non-classical 11β-hydroxylase deficiency caused by a novel heterozygous mutation: a case report and review of the literature.

11β-hydroxylase deficiency (11β-OHD) constitutes a rare form of congenital adrenal hyperplasia (CAH), typically accounting for ~5-8% of CAH cases. Non-classical 11β-OHD is reported even more rarely and frequently results in misdiagnosis or underdiagnosis due to its mild clinical symptoms. A clinical, biochemical, radiological, and genetic study was conducted on a 9-year-old girl presenting with mild breast development, axillary hair growth, and advanced bone age. Additionally, a comprehensive review and synthesis of the literature concerning 11β-OHD were conducted. The patient presented with breast enlargement, axillary hair development, and accelerated growth over the past year. Laboratory tests revealed levels of cortisol, luteinizing hormone, testosterone, and progesterone that were below normal. A gonadotropin-releasing hormone (GnRH) stimulation test suggested the possibility of central precocious puberty. Radiologic examination revealed a 2-year advance in bone age, while bilateral adrenal ultrasonography showed no abnormalities. Her mother exhibited hirsutism, while her father's physical examination revealed no abnormalities. Whole-exon genetic testing of the child and her parents indicated a heterozygous mutation of c.905_907delinsTT in exon 5 of the 11β-hydroxylase gene (CYP11B1) in the child and her mother. This mutation resulted in a substitution of aspartic acid with valine at amino acid position 302 of the coding protein. This frameshift resulted in a sequence of 23 amino acids, culminating in a premature stop codon (p.Asp302ValfsTer23). A review of the previous literature revealed that the majority of heterozygous mutations in 11β-OHD were missense mutations, occurring primarily in exons 2, 6, 7, and 8. The most common mutation among 11β-OHD patients was the change of Arg-448 to His (R448H) in CYP11B1. Furthermore, bioinformatics analyses revealed that heterozygous mutation of c.905_907delinsTT had deleterious effects on the function of CYP11B1 and affected the stability of the protein, presumably leading to a partial impairment of enzyme activity. The results of the in vitro functional study demonstrated that the missense mutant (p.Asp302ValfsTer23) exhibited partial enzymatic activity. We report a novel heterozygous mutation of CYP11B1 (c.905_907delinsTT), enriching the spectrum of genetic variants of CYP11B1. This finding provides a valuable case reference for early diagnosis of non-classical patients with 11β-OHD.

Assessment of the effects of bean extract on axillary hair reduction.

Body hair removal plays an important role in beauty standards, particularly for women. Finding a method that is easy to use, cheap, and can be done without supervision can significantly affect long-term hair reduction and reduce the side effects of hair removal. The present study investigated the impact of a containing 20% broad bean (Vicia faba) extract cream on axillary hair removal. Twenty-five female volunteers were randomly divided into A (right axillary intervention - left axillary placebo) and B (right axillary placebo - left axillary intervention). Depending on the group, each person used a cream containing 20% broad bean extract )"The extract made from the seeds and pods of broad beans.") on one side and a placebo on the other twice a day for three months. Volunteers shaved their axillary hairs three days before each visit and took pictures of both sides on the day of the visit with a trichoscope (to check the diameter and thickness of the hairs). We found a decrease in thickness on the intervention group (the axilla where a cream containing broad bean extract was applied); however, this difference was not significant between the intervention side and the placebo. In terms of the number of hairs, the difference between the two groups was significant only in the second month despite the decrease on the intervention side. Evaluation based on the personal judgment of the volunteers showed that there was a substantial difference in terms of the number of hairs (p=0.012) and thinning of hair (p=0.02). Our findings showed that 20% broad bean extract cream could potentially reduce axillary hair growth.

Evaluation of the Incidence of Low Testosterone Levels in Young Male Adults with Moderate to Severe Obesity-Single-Centre Study from India.

With the increase in obesity epidemic among Asians, it is necessary to evaluate the impact of obesity on this population. Low testosterone levels are known to be associated with obesity. This is the 1st study from Asia to evaluate incidence and magnitude of hypotestosteronemia in young adults with BMI more than 32.5kg/m2 defined as moderate to severe obesity in Asians. One hundred thirty-four male patients with BMI more than 32.5kg/m2, between 18 and 30years old who visited a single bariatric facility between 2017 and 2020, were evaluated with BMI, total and free testosterone levels and clinical features of gynecomastia, hypogonadism, and thinning of pubic and armpit hair. Statistical analysis was performed using SPSS, Spearman's correlation coefficient, and ANOVA test. 60.4% of patients (84/134) had low testosterone levels (< 300ng/dl) and 23.9% (32/134) had levels between 300 and 400ng/dl. 89.6% patients (120/134 had gynecomastia, 60.4% (81/134) had thinning of pubic and arm pit hair, and 62.7% (84/134) had hypogonadism. Testosterone levels showed a decreasing trend with increasing BMI, but it was not statistically significant. Obesity is one of the important etiologies of hypotestosteronemia and its manifestations in young adults. The actual incidence may be significantly higher than what is reported in the literature. High-quality research is required to address questions of diagnosis and best treatment options.

Music as aposematic signal: predator defense strategies in early human evolution.

The article draws attention to a neglected key element of human evolutionary history-the defense strategies of hominins and early humans against predators. Possible reasons for this neglect are discussed, and the historical development of this field is outlined. Many human morphological and behavioral characteristics-musicality, sense of rhythm, use of dissonances, entrainment, bipedalism, long head hair, long legs, strong body odor, armpit hair, traditions of body painting and cannibalism-are explained as predator avoidance tactics of an aposematic (warning display) defense strategy. The article argues that the origins of human musical faculties should be studied in the wider context of an early, multimodal human defense strategy from predators.

Trichomycosis axillaris: Case report

Trichomycosis axillaris is a bacterial infection commonly caused by Corynebacterium. This condition usually affects the axillary and pubic hair, but it also can be seen on the scalp. It may have three different presentations: trichomycosis flava, rubra and nigra; it is characterized by the presence of concretions around the hair. Despite it is not uncommon, doctors outside of dermatology underdiagnosis this condition of the skin. Herein, we report a 70-year-old male patient, who visited the clinic for a post-lesional melanoderma affecting the right armpit. During the physical examination he was found to have a trichopathy localized at the axillary hair, consisting of multiple yellow axillary hairs. Dermoscopy and microscopy showed sheath and nodules around the hair. With these clinical features the patient was diagnosed with post-lesional melanoderma and axillary trichomycosis. Key words: Hair diseases, Corynebacterium infections, Corynebacterium

Body hair removal: A cross-sectional survey among women in the north of Morocco

ABSTRACT Objectives: Our study aimed to determine the prevalence and techniques of body hair removal. In addition, we also looked at the various complications that had arisen in our patient group. Materials and Methods: An online, anonymous, cross-sectional survey was conducted in the north region of Morocco to collect data that was sent to participants who live in one of the cities of northern Morocco. IBM SPSS, version 25, was employed to analyze the data with descriptive and inferential statistics. Results: A total of 660 randomly selected women responded to the questionnaire. The mean age was 31.02 ± 8.89 (SD). Pubic and axillary hair were the most often depilated areas (90–94%). The main reason was hygiene (46.9%). Age, income, family situation, and social status were significantly associated with body hair removal areas and methods. The complications that occurred in different parts of the body were minimal and similar to those already reported in the literature for pubic grooming. They were mainly associated with the technique of removal. Conclusion: Younger women were more likely to remove hair from the face, forearms, and legs when compared to the older. Traditional techniques such as waxing and shaving were still the most often employed. Key words: Body areas, Complications, Hair removal, Regional survey, Techniques What is known about this subject in regard to women and their families? Hair removal is above all a women’s issue. Although the practice is highly popular, there are still complications related to various hair removal methods. What is new from this article as messages for women and their families? There is no previously published data on the prevalence, techniques, and complications of body hair removal among women in our region. More effort is needed to educate women to choose the most appropriate technique with fewer complications.

Progressive Oestrogen Deficiency in a Young Woman with 45X/46XX Mosaicism: A Case Report

Oestrogen is a vital hormone for woman’s health. Naturally, oestrogen hormone level begins to gradually decline leading to related symptoms after the age of 40 years in most women. This case report illustrates a progressive oestrogen deficiency in young woman since she was 19 years old. She was having hypomenorrhea for a year followed with amenorrhoea and was managed conservatively including progestogen challenge for about a year. She responded to the treatment once and remained amenorrhoeic thereafter. She was referred to our centre at 22 years old for further evaluation of premature ovarian insufficiency primarily concerning her fertility. Clinical examination showed a thin young woman with breasts, axillary and pubic hair of Tanner Stage 3. Blood investigation showed low oestrogen level with persistently high gonadotrophins suggestive of primary ovarian insufficiency. The urogenital pelvic ultrasound showed a small thin uterus with normal ovaries. She was diagnosed with Turner Syndrome of 45X/46XX mosaicism based on a blood karyotype test. The lack of typical feature of Turner Syndrome in this case had delayed the initial investigations and management. This case report aimed to highlight on the importance of a comprehensive evaluation in young women presenting with chronic oestrogen deficiency state. This will allow an early diagnosis and treatment of rare condition like mosaic Turner Syndrome and thus, preventing complications.

Adjustment to Pubertal Changes among Adolescent Girls

Background and Objectives: Adolescence is the transitional stage of life from childhood to adulthood characterized by puberty. Dramatic physical, physiological, hormonal, and emotional changes occur, which are exciting as well as frightening at the same time. The objective of this study was to find out the adjustment of adolescent girls towards pubertal changes.&#x0D; Materials and Methods: A descriptive cross-sectional study was conducted to find out the adjustment toward pubertal changes among adolescent girls studying in Grades 8, 9, and 10. A proportionate stratified random sampling technique was used to collect the samples, and a self-administered structured questionnaire was used. Descriptive statistics was used to analyze the data.&#x0D; Results: All the respondents had experienced a rapid increase in height, weight, and development of breast bud, almost all (92.8%) had experienced pubic hair growth, the majority (85.6%) had experienced axillary hair growth, and three-fourths (76%) had experienced pimples on the face. Most (88.8%) of the respondents had received pre-information about pubertal changes. During menarche, more than two-thirds (68.0%) were restricted from worshipping, 20.8% were restricted from seeing or talking to male family members, 17.6% were restricted from cooking and doing household work, and 16.0% were kept in a separate room or neighbor’s house. Nearly three-fourths (74.4%) of the respondents used sanitary pads during their menarche. Similarly, more than three-fourths (77.6%) of the respondents experienced problems during menarche, and the majority (80.4%) had lower abdominal pain. Regarding emotional changes, nearly two-thirds (63.2%) had frequent mood swings, and nearly half (45.6%) shared their feelings with family members and friends.&#x0D; Conclusion: Almost all the respondents have adjusted well to the pubertal changes, but restriction during menarche is still prevalent which needs to be addressed for respectful care during menstruation.