George Rosalyn, Clarke Shari, Thiboutot Diane
Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
Semin Cutan Med Surg. 2008 Sep;27(3):188-96. doi: 10.1016/j.sder.2008.06.002.
Acne affects more than 40 million people, of which more than half are women older than 25 years of age. These women frequently fail traditional therapy and have high relapse rates even after isotretinoin. Recent advances in research have helped to delineate the important role hormones play in the pathogenesis of acne. Androgens such as dihydrotestosterone and testosterone, the adrenal precursor dehydroepiandrosterone sulfate, estrogens, growth hormone, and insulin-like growth factors may all contribute to the development of acne. Hormonal therapy remains an important part of the arsenal of acne treatments available to the clinician. Women dealing with acne, even those without increased serum androgens, may benefit from hormonal treatments. The mainstays of hormonal therapy include oral contraceptives and antiandrogens such as spironolactone, cyproterone acetate, or flutamide. In this article, we discuss the effects of hormones on the pathogenesis of acne, evaluation of women with suspected endocrine abnormalities, and the myriad of treatment options available.
痤疮影响着超过4000万人，其中半数以上为25岁以上的女性。这些女性常常对传统治疗方法无效，即便在使用异维A酸治疗后复发率仍很高。最近的研究进展有助于明确激素在痤疮发病机制中所起的重要作用。诸如二氢睾酮和睾酮等雄激素、肾上腺前体硫酸脱氢表雄酮、雌激素、生长激素以及胰岛素样生长因子都可能促使痤疮的发生。激素治疗仍然是临床医生可用的痤疮治疗手段中的重要组成部分。患有痤疮的女性，即使那些血清雄激素水平未升高的女性，也可能从激素治疗中获益。激素治疗的主要药物包括口服避孕药以及抗雄激素药物，如螺内酯、醋酸环丙孕酮或氟他胺。在本文中，我们讨论了激素对痤疮发病机制的影响、对疑似内分泌异常女性的评估以及现有的众多治疗选择。
