Hirsutism can be caused by all of the following, EXCEPT:
Correct Answer: Spironolactone
Description: Spironolactone 50-100 mg twice daily orally on days 5-25 of menstrual cycle or once daily if used concomitantly with oral contraceptive is a treatment for Hirsutism in adults, due to it's anti-androgen effects. Impoant Learning: Causes of hirsutism: Idiopathic or familial Polycystic ovary syndrome accounts for more than 50% of all cases of hirsutism associated with elevated testosterone levels Steroidogenic enzyme defects: Approximately 2% of adult-onset hirsutism is due to paial defect in adrenal 21-hydroxylase Other causes which are rare include : Acromegaly, ACTH-induced Cushing syndrome, Adrenal carcinoma, Genetic coisol resistance, Maternal virilization during pregnancy due to luteoma of pregnancy, Hyperreactio luteinalis, Diffuse stromal Leydig cell hyperplasia in postmenopausal women, Acquired hyperichosis lanuginosa (diffuse fine hair growth on face and body in association with malignancy, especially colorectal cancer) Pharmacologic causes include: Minoxidil, Cyclosporine, Phenytoin, Anabolic steroids, Diazoxide and some progestins Ref: Ehrmann D.A. (2012). Chapter 49. Hirsutism and Virilization. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
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