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In the past 10 years hirsutism has been the object of a
considerable number of fundamental studies. It provides
endocrinologists with an experimental model for the investigation
of androgen secretion, metabolism and mechanism of action. Plasma
androgen assay, free testosterone measurement, hepatic and
extrahepatic androgen metabolic clearance and androgen metabolism
in the skin are the different steps which were studied by many
groups and represent valuable parameters of the mechanisms of
hirsutism. Determination of the origin of androgen oversecretion
has become easier by technical progress in differential effiuent
venous catheterism, which makes it possible to compare androgens in
adrenal or ovarian effiuent veins to their peripheral levels, and
to determine the ovarian or adrenal source of the androgen
oversecretion as well as the side responsible, essential in the
case of tumors. The study of androgen metabolism and the discovery
of androgen receptors in the skin confIrm the latter as an actual
target cell for androgens. This target cell uses the circulating
active androgen, i. e., testosterone and can also metabolize local
inactive androgens into active ones. This is the case of
androstenedione and dehy droepiandrosterone which are the two main
androgens secreted in women, since women secrete very little
testosterone. The capacity of the skin to transform inactive
androgens into active ones varies from one individual to another.
That would support the concept of variable skin receptivity from
one woman to another and from one ethnic group to another."
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