[Prediction of increased levels of androgen in women with acne vulgaris using ultrasound and clinical parameters].
OBJECTIVE
The aim of our study was to identify clinical parameters characterizing women with acne whose dermatological problems are due to increased androgen production. Identification of these parameters would allow to indicate endocrinological examination in only a proportion of women with acne vulgaris.


METHODS
A total of 54 women with acne vulgaris resistant to local treatment were enrolled in the study. The following clinical parameters were monitored: hirsutism (Ferriman-Gallway score), severity of acne, association of the severity of acne with the menstrual cycle, beginning of manifestations of acne, regularity of the menstrual cycle, presence of alopecia, age at menarche, body weight, BMI and ultrasound investigation of the ovaries. In the standard phase of the cycle, blood was collected to determine the levels of the following hormones: LH, FSH, PRL, TSH, testosterone, androstenedione, DHEA, DHEAS, SHGB. Wilcoxon's robust non-parametric paired test was employed for statistical data analysis.


RESULTS
Overall, 33 (61%) women showed increased levels of at least one androgen. An irregular cycle was found in 21 (39%) women, acne severity was associated with the menstrual cycle in 16 (30%) women, 48 (89%) women had acne from menarche, 19 (35%) women had hirsutism; an ultrasound finding of polycystic ovaries was revealed in 32 (59%) women. No significant differences were found between a sub-group of women with levels of at least one androgen above the upper reference limit and the other women in the following variables: age, weight, BMI, age at menarche, ultrasound finding of polycystic ovaries, manifestation of acne from menarche, irregular cycle, hirsutism. The two groups were not different in the severity of acne. Deterioration of acne depending on the menstrual cycle was more often present in women with normal androgen levels. By contrast, a regular menstrual cycle was found to be more frequent in women with raised androgen levels, although the difference was not statistically significant.


CONCLUSIONS
Clinical parameters had no association with androgen overproduction. Evaluation of clinical parameters, including severity of acne, does not allow to refer only a proportion of women with acne resistant to local treatment for endocrinological examination.
Cibula
D
D
Gynek.-porod. klinika 1. LF UK a VFN, Praha.
Hill
M
M
Fanta
M
M
Skrenková
J
J
Vohradníková
O
O
Kudynová
J
J
Zivný
J
J
D000152:Acne Vulgaris / Q000097:blood* / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood*; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D010053:Ovary / Q000000981:diagnostic imaging*; D014463:Ultrasonography
D000728:Androgens