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An unusual case of hirsutism

¹ Division of Endocrinology and Metabolism, Université de Sherbrooke, Canada
² Division of Endocrinology, Hôpital Saint Luc du Centre hospitalier de l’Université de Montréal, Canada

Correspondence to:
Correspondence to:
Dr Pierre Maheux
Division of Endocrinology and Metabolism, Université de Sherbrooke, 3001–12th Avenue North, Sherbrooke, Québec, Canada J1H 5N4; Pierre.Maheux@USherbrooke.ca

Keywords: hirsutism; porphyria

The first 150 words of the full text of this article appear below.

A 25 year old HIV positive woman presented with a progressive history of hirsutism (fig 1A) unresponsive to oral contraceptives and cyproterone acetate. During the summer, bullous lesions appeared on the dorsal area of both hands (fig 1B). Laboratory studies disclosed the following values: plasma free testosterone 14 pmol/l (normal 2.4–12.5), DHEA-S 14 mmol/l (normal 1.1–9.2), alanine aminotransferase 65 UI/l (normal <20), aspartate aminotransferase 90 UI/l (normal <20), and alkaline phosphatase 116 UI/l (normal 28–36). A 24 hour urine collection showed raised concentrations of uroporphyrin (4908 µg, normal <25), heptacarboxyporphyrin (2030 µg, normal <7), hexacarboxyporphyrin (113 µg, normal <6), and pentacarboxyporphyrin (264 µg, normal <7). The coproporphyrin level was 136 µg (normal <110). Porphyria cutanea tarda is usually sporadic and caused by a diminution in the activity of liver uroporphyrinogen decarboxylase. The manifestations include a bullous dermatosis on sun-exposed areas, poikilodermatous scarred areas dotted with milia, hyperpigmentation, facial . . . [Full text of this article]