Assessment of androgens in women with adult-onset acne.
BACKGROUND
Acne is generally recognized as a disorder of young adults; however, the referral of patients aged over 25 years with acne is increasing. Disturbed androgen production in the ovaries or adrenal gland and impaired plasma transport of androgens in women with adult-onset acne or acne associated with hirsutism have been described.


METHODS
Thirty-five white women with adult-onset acne (onset after the age of 25 years) and hirsutism (A + H), 35 white women with adult acne without hirsutism (A - H), and 35 age-matched white female controls were recruited in this case-control study. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone, dihydroepiandrosterone sulfate (DHEA-S), and sex hormone binding globulin (SHBG) were determined in all patients and compared.


RESULTS
The mean SHBG, free androgen index (FAI), and DHEA-S were significantly different between A + H and control subjects. The only significant difference between A - H and control subjects was observed for DHEA-S.


CONCLUSIONS
DHEA-S plays a key role in the pathogenesis of adult-onset acne. Measurement of circulating androgens, including DHEA-S, especially in patients presenting with adult-onset acne and hirsutism, is helpful, and patients with elevated levels can benefit from hormonal therapy.
Seirafi
Hassan
H
Department of Dermatology, Razi Hospital, Tehran, Iran. hassan_sierafi@yahoo.com
Farnaghi
Farshad
F
Vasheghani-Farahani
Amir
A
Alirezaie
Najmeh-Sadaat
NS
Esfahanian
Fatemeh
F
Firooz
Alireza
A
Ghodsi
Seyedeh Zahra
SZ
D000152:Acne Vulgaris / Q000097:blood*; D000328:Adult; D000728:Androgens / Q000097:blood*; D016022:Case-Control Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006628:Hirsutism / Q000097:blood*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood*
D000728:Androgens; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone