Hirsutism ke lefu le amang basali feela, le khetholloang ka ho eketseha ha moriri oa litelu, torso ... mohloli oa mahlomola a maholo a kelello ho basali ba amehileng.

Tlhaloso ea hirsutism

Ena ke tsoelo-pele e feteletseng ea ho hōla ha moriri libakeng tsa banna (litelu, torso, mokokotlo, joalo-joalo) ho tloha lilemong tsa bocha kapa ka tšohanyetso ho mosali e moholo.

Hirsutism kapa moriri o feteletseng?

Re khetholla hirsutism ho eketseha ha moriri o tloaelehileng oa ho hōla (matsoho, maoto, joalo-joalo) o bitsoang hypertrichosis. Ka hona, moriri o tsoang ho hypertrichosis o ama feela libaka tse tloaelehileng ho basali, empa moriri o molelele, o teteaneng le o motenya ho feta tloaelo. 

Ho fapana le hirsutism, hyperpilosity ena hangata e se e ntse e le teng bongoaneng mme e ama batho ba bong ka bobeli. Hangata hypertrichosis e tloaelehile haholo 'me e tloaelehile ho pota-pota Mediterranean basin le ho sootho. Ka hona, mekhoa ea phekolo ea li-hormone ha e sebetse 'me ho tlosoa moriri ka laser hangata ho fanoa.

Hirsutism ke pontšo ea phello ea lihomone tsa banna 'meleng oa basali. Ho na le mefuta e meraro ea mantlha ea lihomone tse ka amang kholo ea moriri libakeng tsa banna ho basali:

Li-hormone tsa banna tse tsoang ho ovary (testosterone le Delta 4 Androstenedione):

Keketseho ea bona e kanna ea ba ponahatso ea hlahala ea mahe a bomme e ntšang lihomone tsena tsa banna kapa khafetsa ea li-microcysts tse mae a bomme tse ntšang lihomone tsena (micropolycystic ovary syndrome). Ketsahalong ea ho phahama ha serum testosterone kapa maemo a Delta 4-androstenedione, ngaka e laela ultrasound ea endovaginal ho batla li-pathologies tsena tse peli (li-micropolycystic ovaries kapa hlahala ea mahe a bomme).

Li-hormone tsa banna tse tsoang tšoelesa ea adrenal

Ena ke SDHA bakeng sa De Hydroepi Androsterone Sulfate e patiloeng ke hlahala ea adrenal 'me hangata ke ts'ebetso ea adrenal hyperandrogenism ka keketseho e itekanetseng ea secretion ea 17 hydroxyprogesterone (17-OHP) ebe e hloka tlhahlobo ea stimulation le Synacthène® ho netefatsa hore na ho fumanoa eng. Ho feta moo, hobane e hlahlojoa ka mokhoa o hlophisitsoeng nakong ea tsoalo ka sampuli ea mali ho tloha serethe letsatsing la 3rd la bophelo ka ho lekanya boemo ba 17 hydroxyprogesterone (17-OHP) maling, bothata bo ka ba congenital: ke liketso tsa congenital. adrenal hyperplasia ka khaello ea 21-hydroxylase e amanang le phetoho ea lefutso la eona ho chromosome 6.

Cortisol

Keketseho ea cortisol maling (Cushing's syndrome) e ka ’na ea bakoa ke tšebeliso ea nako e telele ea corticosteroids, tšoelesa ea adrenal e ntšang cortisol, kapa hlahala e ntšang ACTH (homone e ntšang cortisol ho tsoa tšoeleseng ea adrenal).

Lisosa tsa hlahala hangata li hlaha ka tšohanyetso ho mosali e moholo, athe hirsutism e teng lilemong tsa bocha hangata e bakoa ke ts'ebetso ea ovary kapa adrenal hyperandrogenism.

Ka litekanyetso tse tloaelehileng tsa li-hormone le ultrasound e tloaelehileng ea mahe a bomme, e bitsoa idiopathic hirsutism.

Ha ho etsoa, ​​​​ka hona, ka boteng ba hirsutism, ngaka e kopa tekanyo ea mali ea testosterone, Delta 4-androstenedione, SDHA le 17-hydroxyprogesterone (e nang le tlhahlobo ea Synacthène® haeba e phahame ka mokhoa o itekanetseng), cortiluria ha ho belaelloa Cushing. le ultrasound ea mahe a bomme.

Litekanyetso li lokela ho koptjoa ntle le ho noa cortisone, ntle le lithibela-pelehi tsa li-hormone bakeng sa likhoeli tse tharo. Li lokela ho etsoa hoseng hoo e ka bang ka hora ea borobeli hoseng le ka le leng la matsatsi a tšeletseng a pele a potoloho (ha lia lokela ho kōptjoa nakong ea lilemo tse tharo tsa pele tsa nako ea bocha kaha ha li na thuso).

Moriri o thata sefahlehong, sefuba, mokokotlong ... ho basali.

Ngaka e sheba matšoao a mang a amanang le hyperandrogenism (keketseho ea lihomone tsa banna): hyperseborrhea, acne, androgenetic alopecia kapa baldness, mathata a ho ilela khoeli ... kapa virilization (clitoral hypertrophy, lentsoe le tebileng le le hlabang). Matšoao ana a fana ka maikutlo a ho eketseha ha maemo a li-hormone maling, ka hona ha a phehe khang molemong oa idiopathic hirsutism.

Ho hlaha ha matšoao ana ka tšohanyetso ho supa hlahala ha ho kengoa ha bona butle-butle ho tloha bocheng ho tšehetsa haholo ts'ebetso ea ovarian kapa adrenal hyperandrogenism, kapa esita le idiopathic hirsutism haeba litlhahlobo li tloaelehile.

Lintho tse kotsi

Mabaka a kotsi a hirsutism ho basali a kenyelletsa:

• ho nka cortisone ka likhoeli tse 'maloa (Cushing's syndrome)
• botenya: ho ka bontsha bothata ba cortisol kapa ho ba karolo ya polycystic ovary syndrome. Empa hape rea tseba hore mafura a na le tšekamelo ea ho khothaletsa metabolism ea lihomone tsa banna.
• histori ea lelapa ea hirsutism

Khopolo ea ho iphetola ha lintho le mathata a teng

Hirsutism e amanang le hlahala e pepesetsa batho likotsi tse amanang le hlahala ka boeona, haholo-holo haeba e le kotsi (kotsi ea metastases, joalo-joalo).

Hirsutism, ebang ke tumoral kapa e sebetsa, ntle le ts'itiso ea eona ea botle, hangata e rarahanngoa ke makhopho, folliculitis, lefatla ho basali ...

Kalafo ea hirsutism e itšetlehile ka phekolo ea sesosa le motsoako oa ho nka li-anti-androgens le mekhoa ea ho tlosa moriri kapa ea depilation.

Kalafo ya sesosa

Ho tlosoa ha hlahala ea mahe a bomme kapa adrenal, hlahala e ntšang ACTH (hangata e fumaneha matšoafong)… ha ho hlokahala.

Motsoako oa mokhoa oa depilation kapa depilation le anti-androgen

Mekhoa ea ho tlosa moriri kapa ea ho theola moriri e tlameha ho kopanngoa le kalafo ea li-hormone tsa anti-androgen ho fokotsa kotsi ea ho mela hape ho hoholo ha moriri.

Ho tlosa moriri le ho senya

Mekhoa e mengata e ka sebelisoa e kang ho soeufatsa moriri, ho kuta, litlolo tsa depilatory, waxing kapa esita le ho tlosa moriri ka motlakase ofising ea dermatologist e bohloko le e tenang.

Ho na le tranelate e thehiloeng ho eflornithine, molek'hule ea antiparasite eo, e sebelisoang sebakeng sa heno, e thibelang ornithine decarboxylase, e leng enzyme e amehang tlhahisong ea moriri ka follicle ea moriri. Ena ke Vaniqa®, e sebelisoang habeli ka letsatsi, e fokotsa ho hōla ha moriri.

Ho tlosoa ha moriri oa laser ho bontšoa maemong a hirsutism e pharaletseng. E kopantsoe le phekolo ea anti-androgen ho thibela ho khutla hape.

Li-antiandrogens

Lentsoe "anti-androgen" le bolela hore molek'hule e thibela ho tlama ha testosterone (ho ba hantle 5-dihydrotestosterone) ho receptor ea eona. Kaha testosterone ha e sa khona ho fumana li-receptor tsa eona moriring, e ke ke ea hlola e e-ba le phello e susumetsang.

Ho na le tse peli tse sebelisoang mehleng ea kajeno:

• cyproterone acetate (Androcur®) e khutlisetsoa Fora bakeng sa pontšo ea hirsutism. Ntle le ts'ebetso ea eona ea ho thibela li-anti-androgen receptor, e boetse e na le phello ea antigonadotropic (e fokotsa tlhahiso ea androgens ka ho fokotsa ts'usumetso ea pituitary) le inhibition ea 5-dihydrotestosterone / receptor complex boemong ba protheine e tlamang ea androgen. .

Ke progestogen eo hangata e tlamehang ho kopanngoa le estrogen ho etsisa potoloho ea tlhaho ea lihormone tsa basali: hangata ngaka e fana ka letlapa la Androcur® 50 mg / letsatsi le kopantsoeng le estrogen ea tlhaho letlapeng, gel kapa patch, matsatsi a mashome a mabeli. ho tsoa ho mashome a mabeli a metso e robeli.

Ntlafatso ea hirsutism e bonoa feela kamora likhoeli tse 6 tsa kalafo.

• spironolactone (Aldactone®), diuretic, e ka fanoa ka ntle ho label. Ntle le phello ea eona ea anti-androgenic receptor blocking, e thibela testosterone synthesis. Ngaka e fana ka matlapa a mabeli ka letsatsi a 50 kapa 75 mg ho fihlela tekanyetso ea letsatsi le letsatsi ea 100 ho 150 mg / letsatsi, hammoho, matsatsi a leshome le metso e mehlano ka khoeli, ka progestogen e seng ea androgenic ho qoba mathata a potoloho. Joalo ka cyproterone acetate, phello e qala ho bonoa feela kamora likhoeli tse 6 tsa kalafo, ka linako tse ling ka selemo.