# Non-classical Congenital Adrenal Hyperplasia Presenting With Severe Androgenic Alopecia: A Case Report

## TL;DR

A 37-year-old woman with severe hair loss and acne was diagnosed with non-classical congenital adrenal hyperplasia and treated with prednisolone.

## Contribution

This case highlights NCCAH presenting with severe androgenic alopecia as a rare clinical manifestation.

## Key findings

- Elevated 17α-hydroxyprogesterone levels confirmed the diagnosis of non-classical CAH.
- Prednisolone treatment was initiated to manage symptoms and improve fertility outcomes.
- The patient exhibited hyperandrogenic symptoms despite normal menstrual cycles.

## Abstract

Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder with cortisol synthesis impairment, commonly due to CYP21A2 gene mutations. Non-classical CAH (NCCAH) presents with hyperandrogenic symptoms such as acne, hirsutism, severe androgenic alopecia, and infertility. We report a 37-year-old female who presented with severe acne, progressive hair loss, and primary infertility despite regular menstrual cycles. Laboratory tests were normal except for elevated 17α-hydroxyprogesterone (17-OHP). Prednisolone was initiated to manage symptoms and address fertility.