Hirsutism | Figure 1

ReginaldoCastro

Internal Medicine

Hirsutism

34 years old, female. She consumes alcohol and has a family history of Diabetes Mellitus (her mother and sister). The patient came to the health unit for routine exams. She reported that she has been trying to get pregnant for 5 years, without success. On physical examination, the presence of hair in the chin and mandibular region was noted. The patient presents with grade I obesity and her fasting blood glucose is 118 mg/dL.

Is it correct to start an oral antidiabetic, such as Metformin, in this case?
Would any other exam be important for this patient?

Update 1

This patient has hirsutism due to hyperandrogenism. The most common cause is Polycystic Ovary Syndrome. A transvaginal ultrasound determined the cause.

Diagnosis Added
Polycystic Ovary Syndrome.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.
He had a history of hypertension, long-term smoking, and a sedentary lifestyle.
On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back.
She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.
Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

58-year-old Asian female. States she has worms coming out of her body.
Has been to 2 hospitals for TX. Unfortunately, the first hospital took a skin biopsy sent patient home. 2nd hospital sent her to the psych ward for a few hrs then discharged pt home. Patient has a h/o Bachets syndrome. Patient currently is awaiting her dermatologist apt. States she has collected worm like larva in plastic bags. Also can feel them come out of her body.
She also stated her parakeet bird has some sort of white worms protruding at times. Patient feels like her body is under attack from some sort of larva/ worms. Any ideas on what this could be?

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days.
Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.