Metabolism and concentration of androgenic steroids in the abdominal skin of women with idiopathic hirsutism.

The in vitro metabolisms of [4-14C]-labelled DHA, delta 5-diol, delta 4-dione and Test were studied in skin tissue excised from the hairy hypogastric region of three patients diagnosed as suffering from "idiopathic hirsutism". The concentrations of DHA, And, delta 4-dione, delta 5-diol, Test, DHT, DHA-S, And-S, delta 5-diol-S and Test-S were determined in other portions of the same skin tissue. In the knowledge of the concentrations of the androgens and the C19-steroid sulphates in the blood and in the skin tissue, and also of the metabolisms of the main androgen precursors and Test in the hairy abdominal skin, new diagnoses can be established within the group of idiopathic hirsutisms : "pure peripheral hirsutism" and "mixed peripheral hirsutism". In the former the hyperactivity of the enzymes of the skin tissue takes part in the emergence of the disease form, while the latter involves the joint participation of the hyperactivity of the enzymes of the skin tissue and the high level of delta 4-dione in the blood. The picture of the metabolism in the hairy abdominal skin of the hirsute patients was dominated by Test formed in pathologically high amount from the precursors as a consequence of the hyperactivity of 17 beta-HSD. The formation of DHT and the activity of 5 alpha-R were of only secondary importance.