Uysal Gulsum, Sahin Yılmaz, Unluhizarci Kursad, Ferahbas Ayten, Uludag Semih Zeki, Aygen Ercan, Kelestimur Fahrettin
Department of Obstetrics and Gynecology, Adana Numune Education and Research Hospital, Adana, Turkey.
Department of Obstetrics and Gynecology, Erciyes University Medical School, Kayseri, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2017 Apr;211:21-25. doi: 10.1016/j.ejogrb.2017.01.054. Epub 2017 Jan 23.
Acne is not solely a cosmetic problem. The clinical importance of acne in the estimation of androgen excess disorders is controversial. Recently, the Amsterdam ESHRE/ASRM-sponsored third PCOS Consensus Workshop Group suggested that acne is not commonly associated with hyperandrogenemia and therefore should not be regarded as evidence of hyperandrogenemia. Our aim was to investigate whether acne is a sign of androgen excess disorder or not.
This is a cross sectional study that was performed in a university hospital involving 207 women, aged between 18 and 45 years, suffering mainly from acne. The women were assigned as polycystic ovary syndrome (PCOS), idiopathic hirsutism (IH), idiopathic hyperandrogenemia (IHA). Women with acne associated with any of the androgen excess disorders mentioned above were named as hyperandrogenemia associated acne (HAA). Women with acne but without hirsutism and hyperandrogenemia and having ovulatory cycles were named as "isolated acne". Serum luteinizing hormone, follicle stimulating hormone, estradiol, progesterone, 17-hydroxyprogesterone, dehydroepiandrosterone-sulfate (DHEAS), androstenedione, total testosterone and lipid levels were measured.
Acne score was similar between the women with isolated acne and HAA. The most common cause for acne was PCOS and only 28% of the women had isolated acne. 114 (55%) women had at least one raised serum androgen level.
In this study, 72% of acneic women had clinical and/or biochemical hyperandrogenemia. In contrast to the suggestion of ESHRE/ASRM-sponsored third PCOS Consensus Workshop Group, our data indicate that the presence of androgen excess disorders should be evaluated in women presenting with acne.
痤疮并非仅仅是一个美容问题。痤疮在评估雄激素过多症中的临床重要性存在争议。最近，由阿姆斯特丹ESHRE/ASRM主办的第三届多囊卵巢综合征共识研讨会小组提出，痤疮通常与高雄激素血症无关，因此不应被视为高雄激素血症的证据。我们的目的是调查痤疮是否为雄激素过多症的一个迹象。
这是一项横断面研究，在一家大学医院对207名年龄在18至45岁之间、主要患有痤疮的女性进行。这些女性被分为多囊卵巢综合征（PCOS）、特发性多毛症（IH）、特发性高雄激素血症（IHA）。患有与上述任何一种雄激素过多症相关痤疮的女性被命名为高雄激素血症相关性痤疮（HAA）。患有痤疮但无多毛症和高雄激素血症且有排卵周期的女性被命名为“孤立性痤疮”。测量血清促黄体生成素、促卵泡生成素、雌二醇、孕酮、17-羟孕酮、硫酸脱氢表雄酮（DHEAS）、雄烯二酮、总睾酮和血脂水平。
孤立性痤疮女性和HAA女性的痤疮评分相似。痤疮最常见的病因是PCOS，只有28%的女性患有孤立性痤疮。114名（55%）女性至少有一项血清雄激素水平升高。
在本研究中，72%的痤疮女性有临床和/或生化高雄激素血症。与ESHRE/ASRM主办的第三届多囊卵巢综合征共识研讨会小组的建议相反，我们的数据表明，对于患有痤疮的女性，应评估其是否存在雄激素过多症。
