Assessment of androgens in women with adult‐onset acne

Hassan, Sk. Sarif; Farnaghi, Fariba; Vasheghani-Farahani, Amir; Alirezaie, Najmeh-Sadaat; Esfahanian, Fatemeh; Firooz, Alireza; Ghodsi, Saeed

doi:10.1111/j.1365-4632.2007.03411.x

Cited by 58 publications

(69 citation statements)

References 27 publications

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“…Essa pequena discrepância pode refletir aspectos culturais e geográficos da população estudada ou até aspectos metodológicos usados para definir esse corte. 7,10,11,15 GRÁFICO 1: Histograma etário das pacientes na data da consulta GRÁFICO 2: Histograma das idades de início dos sintomas GRÁFICO 3: Histograma do tempo de duração do quadro Algumas variáveis classicamente associadas às mulheres adultas com acne, como o uso de cosméti-cos, irregularidade menstrual e obesidade, não foram corroboradas por este estudo, demonstrando que as características topográficas da acne devem exercer melhor capacidade classificatória, quando ponderada a faixa etária envolvida. Da mesma forma, a história familiar não se mostrou elemento significativamente proeminente entre os grupos, o que não afasta a possibilidade de que ambas as formas tenham ascendên-cia familiar na mesma intensidade; entretanto, o viés de memória não pode ser desconsiderado nesse caso.…”

Section: Discussionunclassified

“…10 Uso de cosméticos, alterações hormonais e nutricionais, coexistência de hirsutismo, dermatite seborreica, alopecia, irregularidade menstrual ou aspectos psicoevolutivos são elementos aventados na explicação dos diferentes padrões clínicos e de histó-ria natural da acne em diferentes grupos populacionais. 8,[11][12][13][14][15][16][17][18][19][20] Há carência de pesquisas epidemiológicas que comparem aspectos clínicos associados à acne feminina juvenil e adulta. O presente estudo objetiva analisar as características clínicas e epidemiológicas associadas às diferentes faixas etárias acometidas por acne nessa população.…”

Section: Introductionunclassified

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Padrões clínicos de acne em mulheres de diferentes faixas etárias

Schmitt

Masuda

Miot

2009

An. Bras. Dermatol.

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Resumo: FUNDAMENTOS: Acne é dermatose comum que acomete ambos os gêneros e todas as faixas etárias. Mulheres apresentam diferentes padrões clínicos da doença, além de frequente persistência da acne após a adolescência. OBJETIVO: Analisar características clínicas e epidemiológicas associadas às diferentes faixas etárias acometidas por acne feminina. MÉTODOS: Estudo transversal envolvendo mulheres com diagnóstico de acne, atendidas em ambulatório de dermatologia geral. Variáveis relacionadas à doença e às pacientes foram avaliadas com o emprego de questionário padronizado. RESULTADOS: Avaliaram-se 103 pacientes, cuja idade média na época da consulta foi 21,7 ± 7,3 anos. Definiram-se dois subgrupos com idade de corte de 21 anos e idades médias de 15,8 ± 2,3 e 28,0 ± 5,1 anos. Houve correlação entre a duração do quadro e a idade das pacientes na consulta (R = 0,7). Observaram-se diferenças entre os grupos nas frequências de uso de contraceptivo oral combinado (OR = 48,1), lesões no colo (OR = 11,6), lesões no dorso (OR = 0,2), predominância na topografia superior da face (OR = 0,1) e idade de início das lesões (OR = 1,8). No grupo de mulheres adultas, 80% relataram iní-cio do quadro antes dos 20 anos. CONCLUSÕES: Identificaram-se padrões clínicos cronológicos e topográficos que caracterizaram a acne feminina em diferentes faixas etárias, alertando para a importância da abordagem diagnóstica e terapêutica individualizada. Palavras-chave: Acne vulgar; Dermatologia; Estudos transversais; Hiperandrogenismo Abstract: BACKGROUND: Acne is a frequent skin disease that occurs in both sexes and all age-groups. Women present several clinical disease patterns; moreover, persistence after adolescence is common. OBJECTIVE: To analyze clinical and epidemiological characteristics associated with different age-groups affected by acne in women. METHODS: Cross-sectional study involving female patients diagnosed with acne, at a general dermatology outpatient clinic. Variables related to disease and patients were assessed through a standardized questionnaire. RESULTS: One hundred and three women were assessed. The average age of patients at the time of the consultation was 21.7 ± 7.3 years. Two groups were defined (cut-off age of 21 years), with means of 15.8 ± 2.3 and 28.0 ± 5.1 years. There was correlation between disease duration and current age (R=0.7). There were group differences among frequencies of covariables: combined oral contraceptive (OR=48.1), lesions located on upper chest (OR=11.6), lesions on upper dorsum (OR=0.2), predominance on upper half of face (OR=0.1) and age at disease onset (OR=1.8). Among adult women, 80% reported acne onset before 20 years of age. CONCLUSION: Chronologic and topographic patterns of female acne in different age-groups were defined, reinforcing the importance of an individualized diagnostic and therapeutic approach.

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Section: Discussionunclassified

Section: Introductionunclassified

Padrões clínicos de acne em mulheres de diferentes faixas etárias

Schmitt

Masuda

Miot

2009

An. Bras. Dermatol.

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“…In addition, some studies have shown a positive correlation between acne severity and serum dehydroepiandrosterone sulfate (DHEA-S) concentration in adult females [26,27], whereas others have shown no link between acne severity and clinical markers of androgenicity [26,28,29]. It is, therefore, still unclear whether acne is mediated by serum androgens, locally produced androgens or a combination of both [13].…”

Section: Pathophysiological Characteristics Of Postadolescent Acnementioning

confidence: 99%

Postadolescent Acne in Females

Holzmann

Shakery

2013

Skin Pharmacol Physiol

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Acne in the adult female often presents as a chronic condition that can have a considerable negative psychological, social and emotional impact on the affected individual. Estimated prevalence rates of adult female acne vary widely according to study type. Case reports and clinical examinations estimate the prevalence of clinical acne at 10-12%, while survey estimates of physiological disease states are as high as 54%. Two subtypes of adult female acne may be defined according to time of onset: ‘persistent' and ‘late-onset', accounting for approximately 80 and 20% of cases, respectively. Postadolescent acne is generally mild-to-moderate in severity and presents with more inflammatory lesions and fewer comedones compared to adolescent acne. Furthermore, the impact of acne on the quality of life is often greater in adult females than in younger individuals. Despite these important differences, the key principles of acne treatment in the adult female do not differ significantly from those of other age groups. However, specific characteristics relating to the adult female should be considered when selecting a treatment regimen.

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“…Increased sensitivity of sebaceous end organ to androgen and increased peripheral metabolism of androgen are other possible mechanisms involved in the development of acne. 2 As there is inadequate evidence on the status of circulating testosterone in patients of acne, this study is undertaken for evaluation. Serum testosterone level estimation is a simple cost effective laboratory test that could give us a clue of disease status.…”

Section: Original Articlesmentioning

confidence: 99%

Association of Serum Testosterone with Acne Vulgaris in Women

Rahman¹,

Sikder

Rashid

et al. 2012

Bangabandhu Sheikh Mujib Medical University Journal

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Background: Androgens enhance the sebum production and follicular keratosis that plays the key role in the aetiology of acne. Objective: To find out the association between serum testosterone and acne vulgaris. Methods: A case control study was carried out for a period of two years in the outpatient department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Female patients having acne vulgaris were selected as case. Healthy control (age and sex matched) were enrolled from the community. Results: The study showed that the mean age of the cases was 22.43 with standard deviation 5.2 years and the mean age of the control was 23.23 with standard deviation 5.9 years. The mean duration of disease was 62.6 months ranging from 12 months to 300 months. All the patients had presented with comedones (blackheads and whiteheads) followed by 94.3% had papules and 58.6% had pustules. Considering the site of lesion, all the patients had acne in the face. Data analysis revealed that the percentage of serum testosterone above normal was found to be high among the cases with acne (10%) whereas below normal level of serum testosterone was found among the control and the difference was statistically significant (p<0.001). Conclusion:The study found a significant association between serum testosterone and acne vulgaris. As serum testosterone is associated with acne vulgaris, testosterone levels should be measured in patients presenting with acne vulgaris especially in treatment resistant cases and anti-androgen treatment may be indicated in cases with elevated testosterone level.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.10980 BSMMU J 2012; 5(1):1-5

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Assessment of androgens in women with adult‐onset acne

Abstract: DHEA-S plays a key role in the pathogenesis of adult-onset acne. Measurement of circulating androgens, including DHEA-S, especially in patients presenting with adult-onset acne and hirsutism, is helpful, and patients with elevated levels can benefit from hormonal therapy.

Cited by 58 publications

References 27 publications

Padrões clínicos de acne em mulheres de diferentes faixas etárias

Padrões clínicos de acne em mulheres de diferentes faixas etárias

Postadolescent Acne in Females

Association of Serum Testosterone with Acne Vulgaris in Women

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