Effects of

Clinical studies have consistently demonstrated a female predominance. Thus, in the greater European series (Cervera et al. 1993), which included 1000 patients, 91% were females, and in the greater American series (Ginzler et al. 1982), which included 1103 patients, 88% were females. In general, this percentage ranges from 78% to 96% in most studies, with a female-male ratio of approximately 10:1. This excess of females is especially noteworthy in the 15- to 64-year-old age group, where ratios of age- and sex-specific incidence rates show a 6- to 10-fold female excess. No such excess was noted in patients 14 years and younger and in those 65 years and older. These age-related differences in the female-male ratios have been considered to be related to hormonal changes.

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