Specific dermatologic features of the polycystic ovary syndrome and its association with biochemical markers of the metabolic syndrome and hyperandrogenism

Objective. To investigate biochemical and metabolic abnormalities in relation with cutaneous features of polycystic ovary syndrome (PCOS). Design. Prospective descriptive analysis. Setting. University-based tertiary care. Sample. One-hundred and fifteen untreated consecutive women diagnosed as having PCOS. Methods. Each woman underwent an evaluation of body habitus, acne, hirsutism, seborrhea, androgenic alopecia and acanthosis nigricans. Associations between cutaneous features and hormonal and metabolic parameters were analyzed by means of multivariate logistic regression models. Main outcome measures. Prevalence of cutaneous features in PCOS and associations among the features and biochemical and metabolic parameters. Results. The prevalence of acne, hirsutism, seborrhea, androgenetic alopecia and acanthosis nigricans was 53%, 73.9%, 34.8%, 34.8% and 5.2%, respectively. Acne was not associated with the hormonal, metabolic and anthropometric variables. Hirsutism had positive associations with total testosterone, fasting glucose and total cholesterol, and a negative association with age. Seborrhea was found to be related with free testosterone, fasting glucose and insulin. A negative association was determined among androgenic alopecia and free testosterone, low-density lipoprotein and insulin. Conclusions. Acne and androgenic alopecia are not good markers for the hyperandrogenism in PCOS. Hirsutism appears to be strongly related with hyperandrogenism and metabolic abnormalities in PCOS women.