[Should infertile women with polycystic ovarian syndrome be treated with metformine?]

Metformin for the treatment of hidradenitis suppurativa: a little help along the way

BACKGROUND

Despite recent insights into its aetiology, hidradenitis suppurativa (HS) remains an intractable and debilitating condition for its sufferers, affecting an estimated 2% of the population. It is characterized by chronic, relapsing abscesses, with accompanying fistula formation within the apocrine glandbearing skin, such as the axillae, ano-genital areas and breasts. Standard treatments remain ineffectual and the disease often runs a chronic relapsing course associated with significant psychosocial trauma for its sufferers.

OBJECTIVE

To evaluate the clinical efficacy of Metformin in treating cases of HS which have not responded to standard therapies.

METHODS

Twenty-five patients were treated with Metformin over a period of 24 weeks. Clinical severity of the disease was assessed at time 0, then after 12 weeks and finally after 24 weeks. Results were evaluated using Sartorius and DLQI scores.

RESULTS

Eighteen patients clinically improved with a significant average reduction in their Sartorius score of 12.7 and number of monthly work days lost reduced from 1.5 to 0.4. Dermatology life quality index (DLQI) also showed a significant improvement in 16 cases, with a drop in DLQI score of 7.6.

CONCLUSION

Metformin helps control HS with minimal side effects and good patient compliance and can represent a further agent in the spectrum of treatments available in the treatment of this disease.

Metformine for psychosis associated with the menstrual cycle in a patient with polycystic ovary syndrome

There are several reports of periodic psychotic disorders that appear in connection with the various phases of the menstrual cycle. Although the pathogenesis of menstrual psychosis has not been systematically investigated, it appears that it might be linked to an estrogen cascade that follows a period of sustained high estrogen levels, as in the case in anovulatory cycles. We present a case of psychosis associated with the menstrual cycle in a patient with polycystic ovary syndrome, a disorder typically characterized by anovulatory cycles, in whom the restoration of normal menstruation with use of metformine led to significant improvement of psychotic symptoms.