Hirsutism bụ ọrịa na-emetụta naanị ụmụ nwanyị, nke a na-eji na-abawanye na ntutu isi nke ajị agba, nrịgo… bụ isi iyi nke nhụjuanya nke uche maka ụmụ nwanyị metụtara.

Nkọwa nke hirsutism

Nke a bụ ikwubiga okwu ókè mmepe nke ntutu isi na mpaghara nwoke (ajị agba, ajị anụ, azụ, wdg) site n'oge uto ma ọ bụ na mberede na nwanyị toro eto.

Hirsutism ma ọ bụ oke ntutu isi?

Anyị na-ama ọdịiche hirsutism site na mmụba nke ntutu isi nkịtị (ogwe aka, ụkwụ, wdg) nke a na-akpọ hypertrichosis. Ya mere ntutu sitere na hypertrichosis na-emetụta naanị ebe nkịtị na ụmụ nwanyị, mana ntutu dị ogologo, dị ogologo ma dị ogologo karịa ka ọ dị na mbụ. 

N'adịghị ka hirsutism, hyperpilosity a na-adịkarị adị n'oge ọ bụ nwata ma na-emetụta ma nwoke ma nwanyị. Hypertrichosis na-abụkarị nke ezinụlọ na ọ na-adịkarị na gburugburu osimiri Mediterenian na agba aja aja. Ya mere ọgwụgwọ hormonal adịghị arụ ọrụ yana iwepụ ntutu laser n'ozuzu ya.

Hirsutism bụ ngosipụta nke mmetụta nke homonụ nwoke na akụkụ ahụ nwanyị. Enwere ụdị homonụ atọ nwere ike imetụta uto ntutu n'akụkụ nwoke n'ime ụmụ nwanyị:

Hormone nwoke sitere na ovary (testosterone na Delta 4 Androstenedione):

Mmụba ha nwere ike ịbụ ngosipụta nke etuto ovarian na-ezobe homonụ nwoke ndị a ma ọ bụ karịa nke microcysts na ovaries na-ezobe homonụ ndị a (micropolycystic ovary syndrome). N'ihe omume nke elu na serum testosterone ma ọ bụ Delta 4-androstenedione ọkwa, dọkịta na-edepụta ihe endovaginal ultrasound ịchọ maka abụọ a pathologies (micropolycystic ovaries ma ọ bụ ovarian tumor).

Hormones nke nwoke sitere na gland adrenal

Nke a bụ SDHA maka De Hydroepi Androsterone Sulfate zoro ezo site na ụbụrụ adrenal na ugboro ugboro ọ bụ hyperandrogenism adrenal na-arụ ọrụ site na mmụba dị oke na nzuzo nke 17 hydroxyprogesterone (17-OHP) wee na-achọ nyocha mkpali na Synacthène® iji kwado nchoputa ahụ. Ọ na-adịkarị obere, n'ihi na a na-enyocha ya n'usoro mgbe a mụrụ ya site na nlele ọbara site n'ikiri ụkwụ n'ụbọchị nke atọ nke ndụ site na ịlele ọkwa nke 3 hydroxyprogesterone (17-OHP) n'ime ọbara, anomaly nwere ike ịmalite: ọ bụ omume nke ọmụmụ. hyperplasia adrenal site na ụkọ 17-hydroxylase jikọtara ya na ngbanwe nke mkpụrụ ndụ ihe nketa ya na chromosome 21.

Cortisol

Mmụba nke cortisol n'ime ọbara (Cushing's syndrome) nwere ike ịbụ n'ihi iji corticosteroids ogologo oge, etuto adrenal na-ezo cortisol, ma ọ bụ tumor secreting ACTH (hormone nke na-ezobe cortisol site na gland adrenal).

Ihe na-akpata tumor na-abụkarị mmalite na mberede na nwanyị toro eto, ebe hirsutism dị n'oge uto na-abụkarị n'ihi ọrụ ovarian ma ọ bụ adrenal hyperandrogenism.

Site na usoro onunu ogwu nke hormonal na ultrasound ovarian nkịtị, a na-akpọ ya idiopathic hirsutism.

Na omume, ya mere, na ọnụnọ nke hirsutism, dọkịta na-arịọ maka ọbara onunu ogwu nke testosterone, Delta 4-androstenedione, SDHA na 17-hydroxyprogesterone (na Synacthène® ule ma ọ bụrụ na ọ bụ moderately elu), cortisoluria na omume nke a na-enyo enyo Cushing. na ovarian ultrasound.

Ekwesịrị ịrịọ usoro onunu ogwu na-ewereghị cortisone, na-enweghị mgbochi mgbochi hormonal maka ọnwa atọ. Ekwesịrị ime ha n'ụtụtụ n'ihe dị ka elekere asatọ nke ụtụtụ na otu n'ime ụbọchị isii mbụ nke okirikiri (e kwesịghị ịrịọ ha n'ime afọ atọ mbụ nke oge ntorobịa n'ihi na ha adịghị mkpa).

Ajị siri ike na ihu, thorax, azụ… na ụmụ nwanyị.

Dọkịta na-achọ ihe ịrịba ama ndị ọzọ metụtara hyperandrogenism (mmụba nke homonụ nwoke): hyperseborrhea, otutu, androgenetic alopecia ma ọ bụ isi nkwọcha, nsogbu ịhụ nsọ… Ihe ịrịba ama ndị a na-egosi mmụba nke ọkwa hormone na ọbara ya mere anaghị arụ ụka maka idiopathic hirsutism.

Mbido mberede nke ihe ịrịba ama ndị a kama na-arụtụ aka na akpụ mgbe ha ji nwayọọ nwayọọ na-etinye ha n'oge uto bụ ihe na-akwado ọrụ ovarian ma ọ bụ adrenal hyperandrogenism, ma ọ bụ ọbụna idiopathic hirsutism ma ọ bụrụ na nyocha ahụ dị mma.

Ihe ize ndụ

Ihe ize ndụ maka hirsutism n'ime ụmụ nwanyị gụnyere:

• na-ewere cortisone ruo ọtụtụ ọnwa (Cushing's syndrome)
• oke ibu: ọ nwere ike igosipụta nsogbu cortisol ma ọ bụ bụrụ akụkụ nke ọrịa ovary polycystic. Mana anyị makwaara na abụba nwere ọchịchọ ịkwalite metabolization nke homonụ nwoke.
• akụkọ ihe mere eme nke ezinụlọ hirsutism

Evolution na nsogbu ga -ekwe omume

Hirsutism jikọtara ya na etuto ahụ na-ekpughere ndị mmadụ n'ihe ize ndụ metụtara etuto ahụ n'onwe ya, ọkachasị ma ọ bụrụ na ọ dị njọ (ihe ize ndụ nke metastases, wdg).

Hirsutism, ma ọ bụ etuto ma ọ bụ ọ na-arụ ọrụ, na mgbakwunye na adịghị ahụ ya mma, na-enwekarị mgbagwoju anya site na otutu, folliculitis, isi nkwọcha n'ime ụmụ nwanyị ...

Ọgwụgwọ nke hirsutism na-adabere na ọgwụgwọ nke ihe kpatara ya na nchikota nke ịṅụ ọgwụ mgbochi androgens na iwepụ ntutu isi ma ọ bụ usoro nkwụsị.

Ọgwụgwọ ihe kpatara ya

Mwepụ nke ovarian ma ọ bụ adrenal tumor, ACTH-secreting tumor (na-adịkarị na ngụgụ)… ma ọ dị mkpa.

Nchikota nke depilation ma ọ bụ usoro nkwụsịtụ na mgbochi-androgen

A ghaghị ijikọta usoro iwepụ ntutu ma ọ bụ nbipu ya na ọgwụgwọ hormonal nke anti-androgen iji gbochie ihe ize ndụ nke itolite ntutu isi.

Mwepụ ntutu na mwepu

Enwere ike iji ọtụtụ usoro dị ka ịcha ntutu, ịcha afụ ọnụ, ude depilatory, ịwasị ma ọ bụ ọbụna iwepụ ntutu isi eletrik n'ụlọ ọrụ ndị na-ahụ maka akpụkpọ ahụ na-egbu mgbu ma na-agwụ ike.

Enwere ude dabere na eflornithine, molecule antiparasitic nke etinyere na mpaghara, na-egbochi ornithine decarboxylase, enzyme na-etinye aka na mmepụta ntutu site na ntutu isi. Nke a bụ Vaniqa® nke a na-etinye ugboro abụọ n'ụbọchị, na-ebelata uto ntutu.

A na-egosipụta iwepụ ntutu isi laser n'ọnọdụ nke hirsutism buru ibu. A na-ejikọta ya na ọgwụ mgbochi-androgen iji gbochie nlọghachi azụ.

Anti androgens

Okwu mgbochi-androgen pụtara na molekul na-egbochi njikọ nke testosterone (ka ọ bụrụ kpọmkwem 5-dihydrotestosterone) na onye na-anabata ya. Dị ka testosterone enweghịzi ohere ịnweta ndị na-anabata ya na ntutu isi, ọ nweghịzi enwe mmetụta na-akpali akpali.

A na-eji abụọ eme ihe ugbu a:

• A na-akwụghachi cyproterone acetate (Androcur®) na France maka igosi hirsutism. Na mgbakwunye na ọrụ mgbochi onye na-anabata androgen, ọ nwekwara mmetụta antigonadotropic (ọ na-ebelata mmepụta nke androgens site na ibelata mkpali pituitary) na mgbochi nke 5-dihydrotestosterone / receptor complex na ọkwa nke protein na-ejikọta androgen. .

Ọ bụ progestogen nke a ga-ejikọta ya na estrogen ka ọ na-eṅomi usoro hormonal nke ụmụ nwanyị: dọkịta na-edekarị mbadamba nkume Androcur® 50 mg / ụbọchị jikọtara ya na estrogen eke na mbadamba nkume, gel ma ọ bụ patch, ụbọchị iri abụọ. n'ime iri abụọ na asatọ.

A na-ahụ ọganihu hirsutism naanị mgbe ihe dị ka ọnwa 6 gachara ọgwụgwọ.

• spironolactone (Aldactone®), diuretic, enwere ike ịnye ya n'enweghị akara. E wezụga mmetụta mgbochi-androgenic nnabata nnabata, ọ na-egbochi njikọ testosterone. Dọkịta ahụ na-edepụta mbadamba nkume abụọ kwa ụbọchị nke 50 ma ọ bụ 75 mg iji nweta ọgwụ kwa ụbọchị nke 100 ruo 150 mg / ụbọchị, na ngwakọta, ụbọchị iri na ise kwa ọnwa, yana progestogen na-abụghị androgenic iji zere ọgba aghara okirikiri. Dị ka cyproterone acetate, mmetụta ahụ na-amalite ịhụ naanị mgbe ọnwa 6 gasịrị, mgbe ụfọdụ otu afọ.