Age-dependent endocrine disorders involved in the pathogenesis of refractory acne in women

Abstract

Acne is a disorder of the pilosebaceous unit, common among adolescents, which may be extended to adulthood. The aim of this study was to assess the prevalence of hormonal disorders in women with acne resistance to conventional therapy. We included 72 women aged between 15 and 36 years (divided in two age groups) who presented to our clinic between May and October 2014, suffering from moderate and severe forms of papulopustular and nodulocystic acne. The subjects were non-responsive to classic dermatological treatment or had clinical manifestation of hyperandrogenism. Based on age, we divided the women into two groups, group I with 40 patients aged 15–22years and group II with 32 patients aged 23–36 years. Using ELISA, a hormonal profile was performed for each patient in days 1–3 of the menstrual cycle including, total testosterone, dehydroepiandrosterone sulfate (DHEA-S), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, prolactin, and plasma cortisol. For statistical analysis we used Stata 13 software. We compared the hormonal profile of the two groups and identified significant differences for: testosterone levels (mean value, 0.64±0.35 vs. 0.97±0.50 ng/ml; p<0.0001), DHEA-S levels (mean value, 0.85±0.27 vs. 1.05±0.33 mg/24 h; p=0.001), prolactin levels (mean value, 281.85±91.113 vs. 353.969±102.841 mIU/ml; p=0.002) and LH levels (14.8±6.7 vs. 20.1±8.2 mIU/ml; p=0.002) were higher in group II. No statistically significant differences were found for estradiol (p=0.588) and cortisol (p=0.182) levels. In conclusion, refractory acne can be the first sign of systemic illness including polycystic ovary syndrome. Thus, for a correct therapeutic approach it is necessary to interpret the clinical and biochemical elements in correlation with the medical history.

Antimicrobial resistance development following surgical site infections

“…Many patients are colonized at admission with MSSA, located mostly in the pharynx, but also in other sites (3). For example, some of the patients in the present study had acne, from which S. aureus was isolated (27). These MRSA subpopulations can be selected through exposure to cefoxitin or oxacillin up to 48 h (28).…”

A study comparing the clinical and hormonal profile of late onset and persistent acne in adult females

“…Hence we found that persistent acne is distinctly different from late onset acne and has profound hyperandrogenic features with underlying adrenal and ovarian dysfunction including PCOS. This also suggests that this group, which can manifest as refractory acne, deserves therapy with antiandrogens . AMH and its interrelationship with various androgenic parameters in adult female acne is a potential precept concept that we propose to investigate further to determine its role in adult female acne.…”

“…This also suggests that this group, which can manifest as refractory acne, deserves therapy with antiandrogens. 35 AMH and its interrelationship with various androgenic parameters in adult female acne is a potential precept concept that we propose to investigate further to determine its role in adult female acne.…”

Impact of Natural Compounds on Neurodegenerative Disorders: From Preclinical to Pharmacotherapeutics

“…The neuroprotective properties of secondary metabolites can be attributed, in part, to their antioxidant capacity and anti-inflammatory potential. Genistein, a secondary metabolite of plant origin, has the structure and function similar to the primary female sex hormone, 17-beta-estradiol [84]. Genistein is capable of attaching itself to the receptive proteins of the female sex hormones and having estrogen-specific hormonal effects, even being able to replace them, triggering either an estrogenic or a regulatory hormonal impact [85].…”