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Gynaecomastia

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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Associated Diseases
BETA

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