Endocrine Abstracts

Objective: To investigate the management of dermatological manifestations associated with PCOS and its management across Europe.

Methods: This multinational retrospective study was conducted from June 2023 to January 2024. All women over 18 years of age attending a first consultation for PCOS from 1st January 2020 to 30th December 2023 in the UK (n=359), Turkey (n=239), Greece (n=92) and Georgia (n=10) were included. Those without PCOS or undergoing follow-up were excluded. Data was collected during the first consultation, including sociodemographic variables, reasons for referral, dermatological manifestations, and treatment before and after consultation. Descriptive statistics were performed with SPSS 28.0.

Results: In total, 700 women were seen for the first PCOS consultation. The most common reasons for referral across all countries were irregular menses (65.7%), hirsutism (61.1%) and acne (38.9%). Irregular menses were the most common reason for referral in the UK (59.6%), Greece (82.6%) and Georgia (100.0%), whereas hirsutism was the most common reason for referral (70.3%) in Turkey. Overall, 74.6% of referrals were made due to women having dermatological concerns (UK: 60.7%, Turkey: 94.1%, Greece: 77.2% and Georgia: 100.0%). In total, 611 (87.3%) women were diagnosed with a form of dermatological manifestation of PCOS after the first consultation. All countries showed a similar trend in dermatological diagnoses made, with hirsutism being most common (UK: 92.5%, Turkey: 71.4%, Greece: 85.5% and Georgia: 100.0%) followed by acne (UK: 34.0%, Turkey: 69.6%, Greece: 78.3% and Georgia: 40.0%) and androgenic alopecia (UK: 16.3%, Turkey: 11.2%, Greece: 10.8% and Georgia: 10.0%). Before the first consultation, laser hair removal was the most popular treatment for hirsutism across all countries (33.4%), followed by the oral contraceptive pill (OCP) (22.4%) and shaving (13.9%). Laser treatment was most popular in Turkey (51.8%), Greece (39.8%) and Georgia (90.0%), whereas shaving was most popular in the UK (26.9%). Following assessment at first consultation, 446 (73.0%) women were commenced on pharmacological treatment for hirsutism. Across all countries, the most common drug prescribed was spironolactone (40.8%), followed by the OCP (35.4%) and metformin (32.1%). In the UK, metformin was the most prescribed drug (54.4%), whereas the OCP was the most prescribed drug in Greece (29.9%) and Georgia (100.0%). Spironolactone was most prescribed in Turkey (68.8%).

Conclusion: Dermatological concerns associated with PCOS comprise a large proportion of referrals to tertiary care. Developing a standardised approach to assess and manage dermatological concerns may minimise variation in care internationally and improve patient outcomes.