Polycystic ovarian syndrome in women with acne

Abstract

Background Acne is a common manifestation of hyperandrogenemia. Polycystic ovarian syndrome (PCOS) is a common endocrine abnormality affecting reproductive aged women. In the female, the most common cause of hyperandrogenemia is PCOS. The purpose of our study was to determine the PCOS in women with acne.  Patients and methods In this observational, cross sectional study, 40 females, aged 15-40 years, with various degree of acne who had not received hormonal treatment, including hormonal contraceptive and antiandrogen therapy, for at least 3 months prior to study and 30 female volunteers (aged 15-40 years) without acne or acne scars were enrolled as controls. The severity of acne was graded as mild, moderate or severe. Clinical data including age, weight, height, body mass index (BMI), menstrual history and androgenic sign (hirsutism, alopecia, acanthosis nigricans) were recorded and hormonal assays and pelvic ultrasonography were done. Clinical parameters (acne with menstrual irregularity) accompanied by other features of hyperandrogenism and/or elevated level of luteinizing hormone (LH ) to follicle-stimulating hormone (FSH) ratio and/or ultrasound picture based upon the presence of multiple small subcapsular cysts (diameter 2-8 mm) with dense echogenic stroma, were used to diagnose PCOS. Results 7.5% patients were obese in case group, which was statistically significant. No statistically significant differences were observed in hormonal profiles (serum LH and serum FSH) but significant differences seen in serum testosterone level and pelvic ultrasound to visualize the polycystic ovary in women with acne. There were 11 (27.5%) women with PCOS among the 40 women with acne; 8 showed PCO picture on ultrasound. 10 cases with elevated LH to FSH ratio. Out of 11 women with PCOS, 1 case was diagnosed only clinically. Control group had also one PCOS (3.3%). Prevalence of PCOS with acne was higher in studied cases than control group, which is statistically significant in our population. Conclusion All women with acne should be considered for underlying PCOS and asked about their menstrual patterns and examined for other sign of hyperandrogenism. Those who have menstrual disturbances should have hormonal profile determination as well as pelvic ultrasonography for ovarian visualization. Early diagnoses and treatment can avoid the possible complications.