The SAHA syndrome

The presence of seborrhoea, acne, hirsutism and alopecia in women has first been summarized as SAHA syndrome in 1982 and can be associated with polycy stic ovary syndrome, cystic mastitis, obesity and infertility. In 1994, the association of these androgen-dependent cutaneous signs, was classified ac cording to their etiology into four types: (1) idiopathic, (2) ovarian, (3) adrenal, and (4) hyperprolactinemic SAHA. The HAIRAN syndrome has been cur rently described as a fifth variant with polyendocrinopathy. The SAHA syndr ome generally occurs in young to middle-aged women and involves either the presence of elevated blood levels of androgens or increased androgen-driven peripheral response with normal circulating androgen levels. Peripheral me tabolism of androgens takes place in various areas within the pilosebaceous unit, as indicated by local differences in the activities of aromatase, 5 alpha -reductase as well as of the presence of the androgen receptors. In c ases of SAHA syndrome, careful diagnostic and clinical evaluation has to be performed in order to identify the cause for peripheral hyperandrogenism a nd to exclude androgen-producing tumors. Treatment will target the etiology , whereas the management in idiopathic cases will aim to improve the clinic al features of SAHA. Copyright (C) 2001 S. Karger AG, Basel.