HAIR-AN Syndrome: Inside Story

  • K R Sharma Pacific Medical College and Hospital, Udaipur, India
  • Abhishek Laddha
  • B S Bomb
  • S Verma
  • H Sharma
Keywords: HAIR-AN syndrome, acanthosis nigricans, hirsutism, hyperandrogenism, insulin resistance.


15-year-old adolescent girl presented with weight gain, irregular menstrual cycle, skin lesions suggestive of acanthosis nigricans and hirsutism. On evaluation, she was found to have elevated testosterone levels with normal FSH, LH and fasting blood sugar, decreased glucose insulin index suggestive of Insulin resistance. In view of above features, diagnosis of hyperandrogenism-insulin resistance-acanthosis nigricans syndrome (HAIR-AN syndrome) was made. This syndrome is considered as a sub-type of polycystic ovary syndrome (PCOS). HAIR-AN syndrome has varied presentation and is usually seen by primary care physician, gynaecologist or dermatologist. Life style modification with weight reduction and drugs such as metformin helps in alleviating the symptoms. With limited resources in our country, diagnosis is frequently delayed leading to systemic complications. Early diagnosis and appropriate treatment would help in preventing complications of obesity, insulin resistance leading to coronary artery disease, Type 2 diabetes mellitus, hyperlipidemia. Depression and suicidal behavior may be associated with it and should be aggressively addressed in young adults suffering from HAIR-AN syndrome.


Download data is not yet available.

Author Biographies

K R Sharma, Pacific Medical College and Hospital, Udaipur, India

Professor, Department of Medicine

Abhishek Laddha

Assistant Professor, Department of Surgery, section Urology and IVF, Pacific medical college, Udaipur , India.

B S Bomb

Professor, Department of Medicine, Pacific Medical College and Hospital, Udaipur, India

S Verma

Medical Officer, RNT Medical College, Udaipur, India. 

H Sharma

Clinical Embryologist, SMS Medical College, Jaipur, India.


1. Friedman CI, Richards S, Kim MH. Familial acanthosis nigricans. A longitudinal study. J Reprod Med 1987;32:531-6.
2. Barbieri RL, Ryan KJ. Hyperandrogenism, insulin resistance, and acanthosis nigricans syndrome: a common endocrinopathy with distinct pathophysiologic features. Am J Obstet Gynecol 1983;147:90-101.
3. R. Azziz, E. Carmina, D. Dewailly et al., “The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report,” Fertility and Sterility, vol. 91, no. 2, pp. 456–488, 2009.
4. R. L. Barbieri and K. J. Ryan, “Hyperandrogenism, insulin resistance, and acanthosis nigricans syndrome: a common endocrinopathy with distinct pathophysiologic features,” American Journal of Obstetrics and Gynecology, vol. 147, no. 1, pp. 90–101, 1983.
5. M. Veilleux-Lemieux and A. D. DiVasta, “Severe hyperandrogenemia and insulin resistance in a 12-year-old girl,” Journal of Pediatric and Adolescent Gynecology, vol. 25,no. 4, pp. e99–e101, 2012.
6. Claman P, Graves GR, Kredenster JV, et al. SOGC clinical practice guidelines. Hirsutism: evaluation and treatment. 2002;24(1):62-73, 77-9.
7. Malik S, Jain K, Talwar P, Prasad S, Dhorepatil B, Devi G, Khurana A, Bhatia V, Chandiok N, Kriplani A, Shah D, Sinha G, Unni J, Patil M, Singh M, Shah P, Chakraborty R, Bhattacharya S, Chatterjee S, Barik S, Vaidya R, Wangnoo SK, Mithal A, Ganie MA, Sinha B, Gopal J, Khadilkar W, Nagpal R, Khanna VK, Verma N, Zaheer A, Sthalekar B, Arya L, Khunger N, Sheth R, Bhatia D, Duggal V, Khadilkar A, Joshi B. Management of Polycystic Ovary Syndrome in India. Fertil Sci Res 2014;1:23-43.
8. M. Peign´e, A. Villers-Capelle, G. Robin, and D. Dewailly, “Hyperandrog´enie f´eminine,” La PresseM´edicale, vol. 42, no. 11, pp. 1487–1499, 2013.
How to Cite
Sharma KR, Laddha A, Bomb BS, Verma S, Sharma H. HAIR-AN Syndrome: Inside Story. Int Arch BioMed Clin Res [Internet]. 2017Sep.23 [cited 2019Nov.19];3(3):3-. Available from: