To the unfortunate woman afflicted with hirsutism, excessive facial and/or body hair represents a serious aesthetic and psychological problem; to her physician, it often presents a frustrating dilemma in diagnosis and management. Usually benign, it may be the sole manifestation of a serious underlying endocrine disorder. Hirsutism has been noted in children with hypothalamic lesions,1 congenital ectodermal dysplasia,2 hypothyroidism,3 polyostotic fibrous dysplasia,4 inanition and wasting, and under body casts worn for long periods of time. The starvation state, also called "the hibernation syndrome," is also associated with hirsutism in adult females; the reason for excessive hair growth is unknown. Pituitary gland tumors are found occasionally in women with signs of virilization including hirsutism; in most instances manifest adrenocortical hyperplasia is present, suggesting mediation through the adrenals.
Hyperplasia or tumor of the adrenal cortex leads to one or a variable combination of two syndromes. If the abnormality