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Polycystic ovary syndrome (PCOS) is an endocrine disorder characterized by oligomenorrhea, hyperandrogenism, and polycystic ovaries. Dermatologic manifestations include acne, hirsutism, androgenic alopecia, acanthosis nigricans, and seborrheic dermatitis. PCOS is associated with impaired glucose tolerance, obesity, decreased fertility, complications in pregnancy, increased risk for endometrial cancer, and possibly, cardiovascular complications. It is phenotypically heterogeneous and manifests in the prenatal period, childhood, or adulthood. Early identification and intervention are important, but diagnosis and management in children and adolescents can be challenging. For example, irregular periods are normal for the first 18 months after m…