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SummaryThis review focuses on the subject of acne in women, a disease that is increasingly common and that can also affect men. Adult acne differs from the type of acne that occurs in teenagers, and it may persist beyond adolescence or have its onset at an older age (adult-onset acne or late acne). Acne can have a negative impact on the quality of life of patients at any age, leading to a negative body image and decrease in self-esteem, and in older patients it can result in discrimination in the workplace and in other social environments. Acne in women must be understood as a specific problem, and here we discuss the pathogenesis, clinical presentation, psychology and treatment of this very prevalent problem.Acne is most common in teenagers, but so-called physiological acne in adults can be seen in 54% of women and 40% of men, and its prevalence does not decrease substantially with age.1,2 The majority of adult cases can be classified as persistent, occurring especially in women, while in boys acne usually disappears after adolescence. However, there are cases of truly late-onset acne (occurring after 25 years of age), 2 and in the last decade there has been an increase in the age of onset, mainly in women aged 20Á5-26Á5 years. Acne in women differs from that seen in adolescents, showing a predominance of papules and pustules, with an absence of comedones. These were cases formerly diagnosed as acneiform eruption and not as true acne, as they were assumed to be precipitated by external agents such as drugs, cosmetics, chemical products etc. 2,3Acne can cause psychological disturbances and have a negative impact on the quality of life of patients at any age, 1 leading to a negative body image and decrease in selfesteem, as well as discrimination in the workplace and in other social environments.4,5 Consequently, successful therapy offers, without doubt, much more than just cosmetic benefits. Acne in women must be understood as a specific problem, different from the form we see occurring in teenagers, and, as such, it must be understood and treated seriously, even in mild cases. PathogenesisAcne has a multifactorial pathogenesis, but the androgenic stimulus of the sebaceous glands certainly plays a role. Despite the fact that sebaceous secretion is under genetic control, acne probably results from an exacerbated response of the pilosebaceous unit to the normal circulating androgen levels.6,7 Studies have found increased levels of circulating androgens in some female patients. [8][9][10] Acne in women is a disorder that is particularly sensitive to hormonal changes during the menstrual cycle, and almost 70% of women who were assessed in a study reported worsening of the lesions during the premenstrual period. 11 Clinical presentationThe severity of acne in women tends to vary from mild to moderate, comprising mainly inflammatory lesions. Two main subtypes can be identified: persistent acne and late-onset acne (beginning after the age of 25 years), which are responsible for 80% and 20% of cases, respectively. 12 Wo...

Serious and peer-reviewed investigations must be performed to certify the efficacy and safety of this procedure.

We present a typical case of dermatofibrosarcoma protuberans with local recurrence 2 months after surgery and, motivated by this patient, make a review of the most important aspects. This is a rare tumor and we call special attention to the fact that its recurrence is extremely frequent, so there is absolute need to observe these patients periodically after surgery.

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