title: Adult female acne and associated risk factors: Results of a multicenter case-control study in Italy.
abstract: BACKGROUND
  The reasons for the appearance of acne in adulthood are largely unknown.
  
  
  OBJECTIVE
  We explored the role of personal and environmental factors in adult female acne.
  
  
  METHODS
  We conducted a multicenter case-control study in the outpatient departments of 12 Italian cities. Cases (n = 248) were consecutive women ≥25 years of age with newly diagnosed acne of any grade. Controls (n = 270) were females diagnosed with conditions other than acne.
  
  
  RESULTS
  In multivariate analysis, a history of acne in parents (odds ratio [OR] = 3.02) or siblings (OR = 2.40), history of acne during adolescence (OR = 5.44), having no previous pregnancies (OR = 1.71), having hirsutism (OR = 3.50), being an office worker versus being unemployed or being a housewife (OR = 2.24), and having a high level of reported psychological stress (OR = 2.95) were all associated with acne. A low weekly intake of fruits or vegetables (OR = 2.33) and low consumption of fresh fish (OR = 2.76) were also associated with acne.
  
  
  CONCLUSIONS
  We did not establish an onset date for acne. Some of our associations may reflect consequences of established acne.
  
  
  CONCLUSIONS
  Lifestyle factors may play an important role for acne development in adulthood, but their role should be further assessed in prospective studies.
authors.affiliation: Study Center of the Italian Group for Epidemiologic Research in Dermatology (GISED), Bergamo, Italy; Dermatology Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Di Landro
authors.affiliation: Study Center of the Italian Group for Epidemiologic Research in Dermatology (GISED), Bergamo, Italy; Department of Dermatology, Inselspital University Hospital, Bern, Switzerland.
authors.forename: Simone
authors.initials: S
authors.lastname: Cazzaniga
authors.affiliation: Dermatology Unit, G. Rummo Hospital, Benevento, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cusano
authors.affiliation: Dermatology Unit, S. Maria Nuova Hospital, Reggio Emilia, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Bonci
authors.affiliation: Dermatology Unit, S. Stefano Hospital, Prato, Italy.
authors.forename: Cardinali
authors.initials: C
authors.lastname: Carla
authors.affiliation: Dermatology Clinic, University of Catania, P.O. "G. Rodolico," A.O.U. Policlinico Vittorio Emanuele, Catania, Italy.
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Musumeci
authors.affiliation: Dermatology Unit, Department of Specialistic, Diagnostic and Experimental Medicine, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Patrizi
authors.affiliation: Section of Dermatology, Department of Clinical and Experimental Medicine, S. Anna University Hospital, Ferrara, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bettoli
authors.affiliation: Dermatology Unit, Istituti Ospitalieri Hospital, Cremona, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Pezzarossa
authors.affiliation: Rare Diseases Dermatology and Cutaneous Immunopathology, UO Dermatology I ASF-University of Florence, Florence, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Caproni
authors.affiliation: Pediatric Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Anna Belloni
authors.initials: AB
authors.lastname: Fortina
authors.affiliation: Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Campione
authors.affiliation: Outpatient Department of Dermatology, Health Local Unit, Taranto, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Ingordo
authors.affiliation: Study Center of the Italian Group for Epidemiologic Research in Dermatology (GISED), Bergamo, Italy; Dermatology Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy. Electronic address: luigi.naldi@gised.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Naldi
authors.affiliation: Group for Epidemiologic Research in Dermatology Acne Study Group.
mesh_terms: D000152:Acne Vulgaris / Q000453:epidemiology* / Q000235:genetics; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D004032:Diet; D005260:Female; D005638:Fruit; D020073:Gravidity; D006628:Hirsutism / Q000453:epidemiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D009790:Occupations; D012008:Recurrence; D012307:Risk Factors; D017747:Seafood; D013315:Stress, Psychological / Q000453:epidemiology*; D014478:Unemployment; D014675:Vegetables
keywords: adult female acne; case-control study; diet; family history; risk factors; stress