Turkderm-Turk Arch Dermatol Venereol. 2021; 55(3): 119-124 | DOI: 10.4274/turkderm.galenos.2021.04382

Factors in the etiopathogenesis of post-adolescent female acne

Ezgi Özkur¹, Damla Demir², Ýlknur Kývanç Altunay¹, Mustafa Demir³, Oktay Tosun^4
1University of Health Sciences Turkey, Þiþli Hamidiye Etfal Training and Research Hospital, Clinic of Dermatology, Ýstanbul, Turkey
²University of Health Sciences Turkey, Ümraniye Training and Research Hospital, Clinic of Dermatology, Ýstanbul, Turkey
³University of Health Sciences Turkey, Ümraniye Training and Research Hospital, Clinic of Radiology, Ýstanbul, Turkey
⁴University of Health Sciences Turkey, Þiþli Hamidiye Etfal Training and Research Hospital, Clinic of Gynecology and Obstetrics, Ýstanbul, Turkey

Background and Design: Post-adolescent acne has been defined as acne that persists or whose onset starts beyond the age of 25 years. The presence of hyperandrogenemia, polycystic ovary syndrome (PCOS), dyslipidemia, and insulin sensitivity play a role in etiopathogenesis of post-adolescent acne in women as shown in previous studies. This study was conducted to investigate these relationships.
Materials and Methods: We included 45 female patients with post-adolescent acne and 30 age, sex, and body mass index-matched healthy controls. Demographic characteristics, clinical signs of hyperandrogenemia, pelvic ultrasound scan, and hormonal assessment including the [total testosterone (TT), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2)] and fasting plasma glucose, and insulin and lipid levels were recorded.
Results: Woman with post-adolescent acne had the marked presence of menstrual abnormalities (37.7%), hirsutism (13.3%), androgenetic alopecia (11.1%), metabolic syndrome (MS) (32.4%), and PCOS (22.2%). Pelvic ultrasound scans showed that 17.8% of the patients had polycystic ovaries. In addition, the percentage of current smokers was significantly higher in the patient group than the controls (p=0.001). TT and LH were significantly higher in post-adolescent acne patients than the controls (p=0.048, and p=0.012, respectively). No significant differences were observed between patients and controls in terms of SHBG, DHEAS, FSH, PRL, E2, and total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride levels. No correlations were observed between these parameters and the severity of acne.
Conclusion: Although laboratory hormonal assessment showed no significant difference, post-adolescent acne patients had marked menstrual irregularities, polycystic ovaries, androgenetic alopecia, hirsutism, and MS. However, insulin resistance and dyslipidemia may not play a major role in the pathogenesis of post-adolescent female acne.

Keywords: Acne, hyperandrogenemia, polycystic ovary syndrome, dyslipidemia, insulin sensitivity

---

Post-adölesan akneli kadýnlarda etiyopatogeneze etki eden faktörler

Ezgi Özkur¹, Damla Demir², Ýlknur Kývanç Altunay¹, Mustafa Demir³, Oktay Tosun^4
1Saðlýk Bilimleri Üniversitesi, Þiþli Etfal Eðitim ve Araþtýrma Hastanesi, Dermatoloji Bölümü
²Saðlýk Bilimleri Üniversitesi, Ümraniye Eðitim ve Araþtýrma Hastanesi, Dermatoloji Bölümü
³Saðlýk Bilimleri Üniversitesi, Ümraniye Eðitim ve Araþtýrma Hastanesi, Radyoloji Bölümü
⁴Saðlýk Bilimleri Üniversitesi, Þiþli Etfal Eðitim ve Araþtýrma Hastanesi, Jinekoloji ve Obstetri Bölümü

Amaç: Post-adölesan akne, 25 yaþýndan sonra baþlayan veya devam eden akne olarak tanýmlanmaktadýr. Daha önce yapýlan çalýþmalarda hiperandrojenemi, polikistik over sendromu (PKOS), dislipidemi ve insülin direnci, etiyopatogenezden sorumlu saptanmýþtýr. Bu çalýþma, postadölesan akne hastalarýndaki etiyopatogenezi aydýnlatmak amacýyla yapýlmýþtýr.
Gereç ve Yöntem: Çalýþmamýza 45 post-adölesan akneli kadýn hasta ve 30 yaþ-cinsiyet-vücut kitle indeksi eþlenmiþ saðlýklý kontrol dahil edildi. Demografik özellikler, hiperandrojenemi bulgularý, pelvik ultrason, serum hormon düzeyleri [total testosteron (TT), seks hormon baðlayan globulin (SHBG), dehidroepiandrosteron sülfat (DHEAS), folikül stimülan hormon (FSH), lüteinizan hormon (LH), prolaktin (PRL), östradiol (E2)], plazma açlýk glukozu, insülin ve lipitler deðerlendirildi.
Bulgular: Post-adölesan aknesi olan kadýn hastalarda menstrüel düzensizlikler (%37,7), hirsutizm (%13,3), androgenetik alopesi (%11,1), metabolik sendrom (%32,4) ve PKOS (%22,2) belirgin olarak artmýþ saptandý. Pelvik ultrasonda hastalarýn %17,8’inde overler polikistik görünümde saptandý. Ayrýca sigara içenlerin oraný, kontrol grubuna göre istatistiksel olarak anlamlý yüksekti (p=0,001). Sadece TT ve LH deðerleri post-adölesan akne hastalarýnda istatistik olarak daha yüksek saptandý (sýrasýyla; p=0,048, p=0,012). SHBG, DHEAS, FSH, PRL, E2, total kolesterol, LDL-C, HDL-C ve trigliseritlerin düzeyinde hasta veya kontrol grubu arasýnda fark saptanmadý. Ayrýca akne þiddetiyle bu deðerler arasýnda korelasyon saptanmadý.
Sonuç: Laboratuvar parametrelerinde fark çýkmamakla birlikte; post-adölesan akneli kadýn hastalarda artmýþ menstrüel düzensizlikler, polikistik overler, androgenetik alopesi, hirsutizm ve metabolik sendrom artmýþ sýklýkta saptanmýþtýr. Ancak insülin direnci ve dislipidemi post-adölesan akne patogenezinde majör bir rol oynamýyor olabilir.

Anahtar Kelimeler: Akne, hiperandrojenemi, polikistik over sendromu, dislipidemi, insülin direnci

---

CITE