The role of antimullerian hormone in the hormonal workup of women with persistent acne.
BACKGROUND
In persistent female acne, PCOS (polycystic ovarian syndrome) is a common finding. To diagnose PCOM (polycystic ovarian morphology), transvaginal - USG is required, which is not possible in virginal women. Also, hyperandrogenemia is not consistently reported.


OBJECTIVE
The aim of the study was to compare the hormonal profile of persistent acne patients with or without PCOS and to assess the role of AMH (antimullerian hormone) in persistent acne patients.


METHODS
A cross-sectional retrospective study of persistent acne patients was undertaken and detailed hormonal assessment and USG was undertaken and patients were divided into two group, those with and without PCOS. The various clinical parameters, AMH and other hormonal levels were compared between the two groups of patients. The predictive value of serum AMH level was evaluated using the receiver operating characteristic (ROC) curve analysis.


RESULTS
Of the 112 patients of persistent acne, 40 (34.7%) were described as PCOS. Mean menstrual cycle length, hirsutism, and PCOM (polycystic ovarian morphology) were significantly more in the PCOS group (P < .0001). AMH was significantly higher in the PCOS group of acne patients as compared to the group without PCOS (6.79 ± 2.79 vs. 2.69 ± 1.23, P < 0.001), and an AMH value of 3.6 ng/mL was predictive of PCOM. Apart from the SHBG levels which were low in both groups (normal range 34.3-147 nmol/L), no other hormonal level was deranged. The total testosterone levels were in the high-normal range.


CONCLUSIONS
AMH is a good tool to diagnose PCOM in persistent acne patients and can be used as a replacement for TV-USG, although it does not correlate with hyperandrogenemia. Low SHBG levels were the most common finding in persistent acne patients and could explain the hyperandrogenism seen in patients.
Dermatology, Maulana Azad Medical College, Delhi, India.
Kabir
K
Sardana
Department of Obstetrics and Gynecology, Indraprastha Apollo Hospital, Delhi, India.
Chanchal
C
Singh
Dermatology, Maulana Azad Medical College, Delhi, India.
Isha
I
Narang
Dermatology, Maulana Azad Medical College, Delhi, India.
Shivani
S
Bansal
Dermatology, Maulana Azad Medical College, Delhi, India.
Vijay K
VK
Garg
D000152:Acne Vulgaris / Q000097:blood* / Q000150:complications; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D019160:Endosonography; D005260:Female; D006628:Hirsutism / Q000209:etiology; D006801:Humans; D008597:Menstrual Cycle; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood
D015415:Biomarkers; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D054304:Anti-Mullerian Hormone
acne; acne vulgaris; infection