Prepubertal acne: a cutaneous marker of androgen excess?
BACKGROUND
Early-onset acne before obvious signs of puberty is an uncommon phenomenon.


OBJECTIVE
The aim of this study was to determine if prepubertal acne is associated with an excess of androgens.


METHODS
Basal and adrenocorticotrophic hormone-stimulated plasma androgen levels were measured and bone age was determined in 15 children with early-onset acne.


RESULTS
A late-onset adrenogenital syndrome caused by 21-hydroxylase deficiency was diagnosed in two children. These children had early pubic hair development and advanced bone maturation. Heterozygosity for 21-hydroxylase deficiency was found in three other children.


CONCLUSIONS
We recommend hormonal evaluation in children with prepubertal acne, especially those with associated advanced bone maturation and early pubarche.
De Raeve
L
L
Department of Dermatology, Free University of Brussels, Belgium.
De Schepper
J
J
Smitz
J
J
D019326:17-alpha-Hydroxyprogesterone; D000152:Acne Vulgaris / Q000097:blood*; D000312:Adrenal Hyperplasia, Congenital; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000365:Age Determination by Skeleton; D017668:Age of Onset; D000728:Androgens / Q000097:blood*; D000735:Androstenedione / Q000097:blood; D001481:Basal Metabolism; D015415:Biomarkers / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D005260:Female; D006579:Heterozygote; D006801:Humans; D006908:Hydroxyprogesterones / Q000097:blood; D008297:Male; D011627:Puberty / Q000097:blood*; D012741:Sexual Maturation; D013255:Steroid 21-Hydroxylase / Q000235:genetics; D013739:Testosterone / Q000097:blood
D000728:Androgens; D015415:Biomarkers; D006908:Hydroxyprogesterones; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone; D000324:Adrenocorticotropic Hormone; D013255:Steroid 21-Hydroxylase