Cutaneous Manifestations in Patients with Polycystic Ovary Syndrome: Their Prevalence and Correlation with Hormonal and Metabolic Parameters

Background: We aimed to determine the prevalence of dermatologic manifestations among an Egyptian PCOS cohort and investigate their correlation with hormonal and metabolic changes. Methods: A cross-sectional study was conducted on 53 patients with PCOS and 50 non-PCOS controls. Focused dermatologic examination was performed to assess hirsutism, acne, androgenic alopecia (AGA), and acanthosis nigricans (AN) using clinical scoring. Serum levels of total & free testosterone (TT, FT), dehydroepiandrosterone sulfate, prolactin, and homeostatic model assessment for insulin resistance (HOMA-IR) were estimated for patients with PCOS, along with pelvic ultrasound. Results: Among our cohort, a significantly higher prevalence of hirsutism, AGA, acne & AN was observed in the PCOS group compared to the non-PCOS group, with prevalence rates of 49%, 45.3%, 39.6%, and 32% versus 10%, 12%, 16%, and 12%, respectively. In PCOS, hirsutism is associated with greater TT and FT. A significant positive correlation exists between the degree of hirsutism and TT & FT (P = 0.0001 and P = 0.0007, respectively). No significant difference in any of the measured parameters in PCOS patients with/without AGA. Patients with PCOS who had acne were younger (P = 0.001). Women with PCOS and AN had higher anthropometrics, HOMA-IR, and serum prolactin. Conclusion: In this Egyptian cohort, cutaneous manifestations were common in PCOS, providing clinical clues. Androgen levels can influence the occurrence & degree of hirsutism in PCOS. Acne and AGA in PCOS can be caused by factors other than hyperandrogenism and insulin resistance. AN in PCOS is related to the metabolic derangement.