title: Assessment of androgens in women with adult-onset acne.
abstract: 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.
authors.affiliation: Department of Dermatology, Razi Hospital, Tehran, Iran. hassan_sierafi@yahoo.com
authors.forename: Hassan
authors.initials: H
authors.lastname: Seirafi
authors.forename: Farshad
authors.initials: F
authors.lastname: Farnaghi
authors.forename: Amir
authors.initials: A
authors.lastname: Vasheghani-Farahani
authors.forename: Najmeh-Sadaat
authors.initials: NS
authors.lastname: Alirezaie
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Esfahanian
authors.forename: Alireza
authors.initials: A
authors.lastname: Firooz
authors.forename: Seyedeh Zahra
authors.initials: SZ
authors.lastname: Ghodsi
mesh_terms: 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*
chemical_list: D000728:Androgens; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone