Androgen metabolism in hirsute and normal females

Despite the small size of the volume, it contains a wealth of comprehensive detail on all aspects of vessel wall interaction relevant to thrombosis. There is an excellent chapter on the naturally occurring circulating anticoagulants and a good update of advances in clinical fibrinolysis with particular attention paid to the therapeutic aspects of coronary thrombolysis. One of the most interesting chapters is related to thrombosis and immune disorders. This would be of particular interest to those practising in rheumatology or immunology. Another chapter is of more general interest to physicians, devoted to the pharmacology of platelet/vessel wall interaction. This gives a comprehensive discussion on the current anti-platelet drugs and their actions. The present state of therapy utilising these drugs is well set out. However, it has to be said that the book requires a detailed background knowledge of the present concepts of blood coagulation, in particular of the prostaglandin metabolic pathways and platelet membrane physiology and the complexities of the activation of coagulation factors. I do not feel it is a book of widespread interest to the general physician or surgeon, but would be more useful to the postgraduate examination candidate. EM Androgen metabolism in hirsute and normal females. R Horton and R A Lobo, guest editors. The editors of this book suggest that because it is multi-authored it may suffer from some overlap and different styles. In fact the sixteen authors have produced an excellent review of androgen metabolism which will be of interest to both dermatologist and endocrinologist. The first half of the book contains an up-to-date summary of the hormonal basis for hirsutism, providing much information on ovarian and adrenal androgen metabolism that is not as yet readily available in any of the larger textbooks. The following three chapters relating to the peripheral action of androgens and the physiology of the pilosebaceous unit are comprehensive and easy to follow. They go some way to clarify why there is such a wide range of serum androgen levels in hirsute patients, in some of whom the levels are normal. The remainder of the book is devoted to therapy and, having made the point that in the majority of these patients the underlying abnormality lies in the end-organ response to androgens, the treatments covered are those which have an effect on the androgen receptors in skin, namely spironolactone and cyproterone acetate. The chapter on spironolactone is of particular interest as …