Abstract :
Background: Acne is one of the most commonest dermatological disorders in young patients. 1. It is a
disease of the pilosebaceous follicular unit. 2. Endocrine mechanisms control the components of sebocyte
function—namely lipid synthesis, proliferation and differentiation. 3. Androgens upregulate the sebaceous
glandular function by binding to the nuclear androgen receptors (ARs). Highest density of these androgen
receptors have been demonstrated in sebaceous glands.
The mechanisms suggested in acne include: Increased circulating levels of androgens, Increased free
androgen levels, Increased local metabolism of androgens in skin and increased tissue sensitivity to
androgens.
Materials and Methods: This case control study was conducted In the department of dermatology,
venerology and leprosy, shadan institute of medical sciences, Hyderabad from February 2019-february-
2020. A total of 50 patients (25 males and 25 females) of moderate to severe acne vulgaris resistant to
conventional treatment were included in the study A total of 50 patients (25 males and 25 females) of
moderate to severe acne vulgaris resistant to conventional treatment were included in the study
Inclusion criteria: Age range: 14 to 35 years
Exclusion criteria: patients who were receiving any systemic drugs, oral contraceptives or hormonal
therapy, pregnant and lactating. 50 age and sex matched healthy acne free subjects were also part of the
study.
Methods: Venous blood samples were collected for the assay of serum testosterone,
dehydroepiandrosterone-sulfate (DHEA-S) and androstenedione (A4A) between 0800-0900 hours.
For testosterone assay three samples were collected at 20 minute intervals and pooled together.
Immediately after collection the red cells were separated and the sera were stored at - 20?C till assay. In
females, the samples were collected only in the first half of the follicular phase of the menstrual cycle. All
hormones were measured by radioimmunoassay using standard techniques with commercially obtained
kits.
Result: All patients included in the study had moderate to severe acne. The commonest lesions encountered
were pustules and nodules while cysts were present in 10/25 males and 11/25 females. 32/50 patients had
acne lesions also on the trunk. The mean duration of acne was 2.6 years (range 1 to 6 years). A history of
partial or no response to conventional treatment was present in all the patients. Mild to moderate degree
of hirsutism was present in 7/25 female patients; of whom 4 also had oligomenorrhea. No other sign of
virilisation was observed in any female patient. In males with acne the mean serum testosterone levels
were only marginally elevated but their DHEA-S levels were significantly higher than in controls.
Keyword :
Acne, Serum testosterone, Dhea-s.