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Signs
 
 

Gynaecomastia

 
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Overview

  • How to Elicit

  • Using the thumb and index finger, gently pinch around the male areola, feeling for enlargement of glandular and ductal breast tissue.
Differentiate from pseudogynaecomastia, as a result of obesity.
  • Abnormal If

  • >2cm of glandular tissue.
  • Causes of Gynaecomastia

  • Physiologic - until puberty
  • Chronic liver disease (decreased oestrogen excretion)
  • Chromosomal - Klinefelter syndrome
  • Testicular - congenital absence, castration, viral orchitis, tumours
  • Hyperprolactinaemia
  • Hyperthyroidism
  • Drugs - anabolic steroids, oestrogens, androgens, growth hormones, finasteride, dutasteride, spironolactone, metronidazole, PPIs
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