Timpatanapong P, Rojanasakul A
Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.
J Dermatol. 1997 Apr;24(4):223-9. doi: 10.1111/j.1346-8138.1997.tb02778.x.
One of the important etiologic factors in acne is an increase in sebaceous gland activity, which is androgen dependent. Acne is a common manifestation of hyperandrogenemia. Therefore, acne may not only cause cosmetic concern but may also be a sign of underlying disease. In females, the most common cause of hyperandrogenemia is polycystic ovary syndrome (PCOS). The purpose of this study was to determine the hormonal profiles of women with acne and the prevalence of PCOS in women attending the dermatological clinic with acne problems. The diagnostic criteria of PCOS were clinical findings of menstrual disturbances and hyperandrogenism (acne, seborrhea, hirsutism), pelvic ultrasound imaging of PCO (multiple subcapsular ovarian cysts 2-8 mm. in diameter, with dense echogenic stroma), and an elevated luteinizing hormone (LH) to follicle stimulating hormone (FSH) ratio. There were 51 women with acne; 20 regularly menstruating volunteers without acne served as a control group. PCOS was found in 19 out of 51 patients with acne (37.3%) and none of the control group. Twenty acne patients had abnormal menstruation (39.2%). Acne cases had higher mean levels of serum total testosterone (T), free T, dehydroepiandrosterone sulfate (DHEAS) and prolactin (PRL). No statistically significant difference was observed for LH, FSH or sex hormone binding globulin (SHBG). Because of this high prevalence of PCOS in women with acne, all women presenting with acne should be asked about their menstrual pattern and examined for other signs of hyperandrogenemia. Hormonal profile determination as well as pelvic ultrasonography for ovarian visualization should be performed to confirm the diagnosis of PCOS in female acne patients who have menstrual disturbances.
痤疮的重要病因之一是皮脂腺活动增加，这依赖于雄激素。痤疮是高雄激素血症的常见表现。因此，痤疮不仅会引起美容问题，还可能是潜在疾病的一个迹象。在女性中，高雄激素血症最常见的原因是多囊卵巢综合征（PCOS）。本研究的目的是确定患有痤疮的女性的激素谱以及在皮肤科诊所就诊的有痤疮问题的女性中PCOS的患病率。PCOS的诊断标准包括月经紊乱和高雄激素血症（痤疮、脂溢性皮炎、多毛症）的临床表现、PCO的盆腔超声成像（多个直径2 - 8毫米的包膜下卵巢囊肿，伴有密集的高回声间质）以及黄体生成素（LH）与卵泡刺激素（FSH）比值升高。有51名患有痤疮的女性；20名月经规律且无痤疮的志愿者作为对照组。51例痤疮患者中有19例（37.3%）被发现患有PCOS，而对照组无一例。20例痤疮患者月经异常（39.2%）。痤疮患者的血清总睾酮（T）、游离T、硫酸脱氢表雄酮（DHEAS）和催乳素（PRL）平均水平较高。LH、FSH或性激素结合球蛋白（SHBG）未观察到统计学上的显著差异。由于痤疮女性中PCOS的患病率较高，所有出现痤疮的女性都应询问其月经模式并检查其他高雄激素血症的体征。对于有月经紊乱的女性痤疮患者，应进行激素谱测定以及盆腔超声检查以观察卵巢情况，以确诊PCOS。
