Förström L
Acta Derm Venereol Suppl (Stockh). 1980;Suppl 89:27-31.
The sebaceous glands are stimulated by androgens produced in the skin itself. This explains why elevated androgen levels are seldom found in blood and urine from patients with acne. The most potent androgen is dihydrotestosterone (DHT), which is formed in the target cells, i.e. in the sebaceous glands, by a 5 alpha-reduction of testosterone. DHT is then bound to a specific receptor protein and translocated into the cell nucleus. In young persons genetically predisposed to acne a temporarily increased local DHT-formation has been postulated. In women androstenedione appears to be the major pre-hormone for DHT-formation. Adrenal androgens may account for prepubertal acne. Estrogens and progesterone influence acne only in high, unphysiological doses. Therapeutically we are waiting for a safe effective anti-androgen for topical use.
皮脂腺受到皮肤自身产生的雄激素刺激。这就解释了为何痤疮患者血液和尿液中很少发现雄激素水平升高。最有效的雄激素是双氢睾酮（DHT），它在靶细胞即皮脂腺中由睾酮经5α还原形成。然后DHT与一种特定的受体蛋白结合并转运到细胞核内。对于有痤疮遗传易感性的年轻人，推测其局部DHT生成会暂时增加。在女性中，雄烯二酮似乎是DHT形成的主要前体激素。肾上腺雄激素可能导致青春期前痤疮。雌激素和孕酮仅在高剂量、非生理剂量时才会影响痤疮。在治疗方面，我们正在等待一种安全有效的外用抗雄激素药物。
