title: Role of hormones and blood lipids in the pathogenesis of acne vulgaris in non-obese, non-hirsute females.
abstract: BACKGROUND
  Acne vulgaris (AV) is a common disease affecting all ages and ethnic groups. Androgens, skin and serum lipids, inflammatory signaling and regulatory neuropeptides seem to be involved in this multi-factorial process.
  
  
  OBJECTIVE
  The aim of this work was to determine hormonal levels and lipid profile in non-obese, non-hirsute females with AV.
  
  
  METHODS
  A total of 60 non-obese, non-hirsute female cases with different grades of AV and 60 age- and gender-matched healthy volunteers were included. Measurement of serum total and free testosterone, sex hormone binding globulin (SHBG), estradiol and progesterone and blood lipids was done during the luteal phase of the menstrual cycle.
  
  
  RESULTS
  Total testosterone, free testosterone (FT) and progesterone levels were significantly higher (P < 0.001 for all) while estradiol levels (P < 0.001) and SHBG (P < 0.01) were significantly lower in cases than controls. Total cholesterol and low density lipoprotein cholesterol (LDL-C) levels were significantly higher (P < 0.001 for both) while high density lipoprotein cholesterol (HDL-C) and apolipoprotein A-1 (ApoA-1) levels were significantly lower (P < 0.001 for both) in cases than controls. Higher values of FT (P = 0.03) and SHBG (P = 0.02) and lower values of estradiol (P = 0.04) levels were significantly in favor of severe acne. Higher values of cholesterol (P < 0.001) and LDL-C (P = 0.03) and lower values of HDL-C (P = 0.01) and ApoA-1 (P = 0.02) levels were significantly associated with severe acne.
  
  
  CONCLUSIONS
  Changes in hormone levels and lipid profile in non-obese and non-hirsute females with AV should be considered in disease pathogenesis and in treatment prescription of these patients.
authors.affiliation: Department of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt.
authors.forename: Ola Ahmed
authors.initials: OA
authors.lastname: Bakry
authors.affiliation: Department of Medical Biochemistry, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt.
authors.forename: Rania Mohamed Azmy
authors.initials: RM
authors.lastname: El Shazly
authors.affiliation: Department of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt.
authors.forename: Shawky Mahmoud
authors.initials: SM
authors.lastname: El Farargy
authors.affiliation: Department of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt.
authors.forename: Dalia
authors.initials: D
authors.lastname: Kotb
keywords: Acne vulgaris; female; hormones; lipid profile