高雄烷基化增多或作用增强所导致的临床表现——高雄烷化增多症，在青春期前女孩中并不罕见。高雄烷化增多症影响3%至20%的青少年女孩，并常常伴随高雄烷血症。对于青春期前的女孩，雄激素过剩的最常见病因是早发性肾上腺皮质增生症（60%）和先天性肾上腺增生症（CAH;4%）。而对于青春期的女孩，多囊卵巢综合征（PCOS；20-40%）和CAH（14%）是与雄激素过剩最常见的诊断。分泌雄激素的卵巢或肾上腺肿瘤非常罕见（0.2%）。早期鬓角头发、痤疮和/或多毛症是最常见的临床表现，但青春期女孩明显毛发或多毛症进展迅速、阴蒂增大、嗓音变深、严重囊性痤疮、生长加速、肌肉质量增加、骨龄超过身高年龄等表现应引起详细评估。本文讨论了在青少年女孩中利用算法进行雄激素过剩诊断评估的临床表现和管理考虑，但排除多囊卵巢综合征的情况。Thieme保留所有权利。

Hyperandrogenism-clinical features resulting from increased androgen production and/or action-is not uncommon in peripubertal girls. Hyperandrogenism affects 3 to 20% of adolescent girls and often is associated with hyperandrogenemia. In prepubertal girls, the most common etiologies of androgen excess are premature adrenarche (60%) and congenital adrenal hyperplasia (CAH; 4%). In pubertal girls, polycystic ovary syndrome (PCOS; 20-40%) and CAH (14%) are the most common diagnoses related to androgen excess. Androgen-secreting ovarian or adrenal tumors are rare (0.2%). Early pubic hair, acne, and/or hirsutism are the most common clinical manifestations, but signs of overt virilization in adolescent girls-rapid progression of pubic hair or hirsutism, clitoromegaly, voice deepening, severe cystic acne, growth acceleration, increased muscle mass, and bone age advancement past height age-should prompt detailed evaluation. This article addresses the clinical manifestations of and management considerations for non-PCOS-related hyperandrogenism in adolescent girls. We propose an algorithm to aid diagnostic evaluation of androgen excess in this specific patient population.Thieme. All rights reserved.