Background
Acne vulgaris in females may appear for the first time at or persist after the age of
25 years and may be resistant to treatment despite topical and systemic therapy for
a sufficient period. In this condition, acne may be a manifestation of an underlying
endocrine condition such as polycystic ovarian syndrome (PCOS).
Objective
The aim of this study was to assess the frequency of PCOS in women with
postadolescent acne.
Patients and methods
This case–control study included 40 female patients with postadolescent acne
vulgaris and 20 acne-free female participants as a control group. Both patients and
controls were subjected to full assessment of history, dermatological examination, and
assay of serum total testosterone, follicle-stimulating hormone (FSH), and luteinizing
hormone (LH). Two of the following criteria were required for the diagnosis of PCOS:
a clinical or a biochemical feature of hyperandrogenism and/or ratio of LH to FSH of at
least 2 and/or ultrasonic findings of PCOS.
Results
The frequency of PCOS among postadolescent acne patients was 37.5 and 5% in the
control group, with a statistically significant difference (P = 0.006). There was no
statistically significant difference between the acne group and the control group
regarding serum levels of total testosterone, FSH, and LH (P = 0.23, 0.14, and 0.86,
respectively). However, statistically significant difference was found between both
groups in the LH/FSH ratio (P = 0.033). Also, there was a highly statistically significant
difference between acne patients with PCOS and those without PCOS in the LH/FSH
ratio and LH (Po0.001 for both).
Conclusion
All women with postadolescent acne should be considered for underlying PCOS.
Hormonal profile and ultrasonography should be performed for patients with
postadolescent acne despite the absence of menstrual irregularities or hirsutism. |
