April 1997

Successful Treatment of Hirsutism in HAIR-AN Syndrome Using Flutamide, Spironolactone, and Birth Control Therapy

Author Affiliations

Ball Memorial Hospital, Muncie, Ind

Arch Dermatol. 1997;133(4):431-433. doi:10.1001/archderm.1997.03890400023003

REPORT OF A CASE  A 15-year-old obese Mexican girl requested treatment for hirsutism of 1 year's duration. She dropped out of school because her classmates called her "monkey face" (Figure 1). Her menstrual periods were regular and she had no acne, hair loss, clitoral hypertrophy, or other signs of virilization. In addition to hirsutism, she had extensive acanthosis nigricans plaques on her neck, groin, and axilla. Her insulin level was 359 pmol/L (50 mU/L) (normal range, 27-150 pmol/L [3.8-21 mU/L]). Her free testosterone level was 29.8 nmol/L (8.6 ng/mL) (normal range, 3.5-18.0 nmol/L [1.0-5.2 ng/mL]). Levels of dehydroepiandrosterone, luteinizing hormone, folliclestimulating hormone, prolactin, and urine porphyrin, blood cell count, and results of other chemistry studies were normal.

THERAPEUTIC CHALLENGE  Our goal was to obtain clinical improvement of the hirsutism allowing the patient to return to social function without undue psychological trauma.

SOLUTION  The patient was treated with flutamide (125 mg

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