Differential Diagnosis for a 28-year-old Woman with Increasing Facial Hair
- Single most likely diagnosis:
- Polycystic Ovary Syndrome (PCOS): This is the most likely diagnosis given the patient's symptoms of hirsutism (increasing facial hair), acne, and amenorrhea (absence of menstrual cycles) after discontinuing oral contraceptive pills. PCOS is a common endocrine disorder in women of reproductive age and is often associated with these symptoms.
- Other Likely diagnoses:
- Idiopathic Hirsutism: This condition is characterized by excessive hair growth in women without any identifiable cause, such as hormonal imbalance. However, the presence of acne and amenorrhea in this patient makes PCOS more likely.
- Hyperandrogenism: This is a condition characterized by elevated levels of male hormones, which can cause hirsutism, acne, and menstrual irregularities. However, the specific diagnosis of hyperandrogenism would depend on further laboratory testing.
- Do Not Miss diagnoses:
- Androgen-Secreting Tumor: Although rare, tumors that secrete androgens (such as ovarian or adrenal tumors) can cause rapid onset of hirsutism, acne, and virilization. It is crucial to rule out these tumors due to their potential impact on health and fertility.
- Cushing's Syndrome: This rare endocrine disorder is caused by excess cortisol production and can lead to hirsutism, acne, and menstrual irregularities, among other symptoms. Early diagnosis is essential due to the potential for serious complications.
- Rare diagnoses:
- Congenital Adrenal Hyperplasia (CAH): This is a group of inherited disorders that affect the adrenal glands, leading to an overproduction of male hormones. Although CAH is typically diagnosed in infancy or childhood, some milder forms may not be diagnosed until adulthood.
- Acromegaly: This rare disorder is caused by excess growth hormone production, which can lead to a variety of symptoms, including hirsutism and menstrual irregularities. However, other characteristic features of acromegaly, such as excessive growth and soft tissue swelling, are not mentioned in the patient's presentation.