EVIDENCE FOR INCREASED ANDROSTERONE METABOLISM IN SOME NORMOANDROGENIC WOMEN WITH ACNE

Increased androgen production from the ovary, adrenal or locally in sk in has been implicated in the pathogenesis of acne. Recent data have p rovided evidence that androsterone (Ao) metabolism is exaggerated in a cne and serum metabolites of Ao differentiate between acne and hirsuti sm in hyperandrogenic women. Here we have extended these studies to no rmoandrogenic women who have moderate to severe acne. We measured seru m ovarian and adrenal androgens as well as the glucuronide and sulfate metabolites of Ao and 3alpha-androstanediol which reflect, in part, p eripheral androgen action. In a group of 15 well-selected normoandroge nic patients with acne, both serum Ao glucuronide (G) and Ao were elev ated (P < 0.01; P < 0.05). The ratios of Ao G to androgen precursors o f both ovarian and adrenal origin were elevated as was the ratio of Ao G/Ao (P < 0.05). These data suggest that increased Ao metabolism is a specific abnormality found in both normoandrogenic and hyperandrogeni c women with acne. Our findings also provide a rationale for antiandro gen therapy at least in some normoandrogenic women with acne.