The role of androgens in determining acne severity in adult women.
BACKGROUND
Although many arguments have been put forth supporting the role of androgens in the aetiology of acne, their part in determining the severity of the disease is not well established.


OBJECTIVE
The aim of our study was to evaluate the relationship between acne severity and the clinical and laboratory markers of androgenicity in a large group of patients.


METHODS
Ninety women over 17 years of age with acne were enrolled into the study. The levels of testosterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulphate and sex hormone binding globulin (SHBG) were measured. Menstrual cycle regularity, hirsutism score, acne severity and ultrasound evaluation of polycystic ovaries were recorded. One-way analysis of variance, chi(2)-test and correlation analysis were used for data processing.


RESULTS
Hirsutism was documented in 19 (21%) subjects, elevated levels of at least one androgen in 73 (81%) subjects, an irregular cycle was reported by 43 (48%) women, and polycystic ovaries were found in 45 (50%) women. The patients were divided into three groups according to acne severity. Acne was graded using the Leeds technique as minor in 43 (48%) cases, mild in 27 (30%) and moderate in 20 (22%). We did not demonstrate a positive correlation between the grade of acne severity and any of the clinical or laboratory markers of androgenicity assessed. On the contrary, women with a higher grade of acne severity showed lower values of the index of free testosterone, a lower hirsutism score and higher SHBG levels.


CONCLUSIONS
Our study suggests that the severity of acne manifestation in adult women is not determined by androgen production.
Cibula
D
D
Department of Obstetrics and Gynecology, General Teaching Hospital in Prague, Charles University, Apolinarska 18, 120 00 Prague 2, Czech Republic. david.cibula@iol.cz
Hill
M
M
Vohradnikova
O
O
Kuzel
D
D
Fanta
M
M
Zivny
J
J
D000152:Acne Vulgaris / Q000097:blood / Q000209:etiology*; D000328:Adult; D000728:Androgens / Q000097:blood / Q000502:physiology*; D005260:Female; D006628:Hirsutism / Q000150:complications; D006801:Humans; D008599:Menstruation Disturbances / Q000150:complications; D011085:Polycystic Ovary Syndrome / Q000150:complications; D011446:Prospective Studies; D012720:Severity of Illness Index; D012738:Sex Hormone-Binding Globulin / Q000032:analysis
D000728:Androgens; D012738:Sex Hormone-Binding Globulin