CLINICAL, ULTRASOUND AND HORMONAL MARKERS OF ANDROGENICITY IN ACNE-VULGARIS

Androgenic stimulation of sebaceous glands is an important factor in t he development of acne, We examined 36 females (aged 14-34 years), sel ected because none had received oral contraceptives, anti-androgen the rapy, or systemic antibiotics during the previous year, or isotretinoi n therapy, prior to their participation in the study. Subjects were di vided into groups on the basis of acne severity, as follows: physiolog ical, mild and moderate. Only two patients had polycystic ovaries on u ltrasound examination, Seven patients had irregular menses; none had e vidence of hirsutism, We found that the severity of acne, based on the acne grade, was highly correlated with the inflammatory lesion count, and less correlated with the sebum excretion rate, Either acne grade or inflammatory lesion count could be related to some of the five andr ogenic hormone determinants; free testosterone (TESTOS), delta 4 andro stenedione (DELTA 4), sex hormone binding globulin (SHBG), dehydroepia ndrostenedione sulphate (DHEAS) and dihydrotestosterone (DHT), Multipl e linear regression analysis determined the best model for predicting ACNE score as involving DELTA 4 and DHEAS (positive effects), and SHBG (negative effect), P < 0.005, R(2) = 0.36), In none of the patients w ere the levels of DHEAS or SHBG outside the normal range, The findings in the two patients with polycystic ovaries did not differ significan tly from those in the remainder of the patients.