Endocrine Abstracts

Introduction: Increased adrenocortical production appears to be associated with acne and hirsutism in PCOS. However, the etiological role of androgens in the pathogenesis of acne per se is far from being clear. In the present study, we aimed to evaluate adrenocortical function in women with post-adolescent severe acne in comparison with patients with PCOS and healthy women.

Design: The study included 32 women with post-adolescent severe acne, 32 women with PCOS and 32 age and BMI-matched healthy controls (age 17–34 years, BMI: 20.8±1.9 kg/m²). Women with acne did not have hirsutism/biochemical hyperandrogenism or ovulatory dysfunction whereas all PCOS patients had androgen excess and ovulatory dysfunction. Measurements included basal testosterone (T), SHBG and DHEAS levels and serum 17-hydroxprogesterone (17-OHP), androstenedione (A4), DHEA and cortisol levels in response to ACTH stimulation.

Results: T, FAI, DHEAS levels, basal and AUC (area under the curve) values for A4 were significantly higher in PCOS than women with acne and controls (P<0.05 for all) whereas three groups did not differ for basal or AUC values of DHEA and cortisol. Women with PCOS and severe acne had significantly and similarly higher AUC values of 17-OHP compared to controls (P<0.05).

Conclusion: Women with isolated post-adolescent severe acne do not have increased levels of adrenal androgens basally or in response to ACTH. However, these women have similar secretion pattern of 17-OHP with PCOS patients suggesting increased enzymatic activity in this pathway.