Clinicoepidemiological study of acne in age more than 25 years with respect to endocrinological evaluation

Abstract

Acne being a common dermatologic disease of adolescents with its varied clinical presentation and recurrence, with relevance of up to 95% in all the population has been difficult to treat. It has been recognised as one of the conditions in Global Burden of Disease (GBD). To study adult acne with clinical history and hormonal evaluation. Patients over the age of 25 years presenting with acne in a tertiary care hospital were included in the study. A detailed history and examination was done, with factors such as alopecia, hirsuitism and menstrual irregularity.Hormonal Investigations and Ultrasound of abdomen and pelvis were done for all patients. Out of 30 patients included in the study 30 were women. The mean age of the patients was 32.52 years. Persistent acne was observed in 50%, while it was late onset in 50% with duration from 1 month to 25 years. Most common grades included grade II with 53%, grade III with 23.33 %, and grade I with 20%. Hirsuitism in 33.33% and alopecia in 6% was also seen. On further investigations it was found that Serum DHEA-S and Serum Testosterone were within normal limits, Prolactin increased in 13.33%, LH reduced in 6.66%, FSH increased in 6.66% and decreased in 3.33%, Fasting Insulin increased in 3.33%, Postprandial Insulin increased in 6.66%. Thyroid profile showed TSH decreased in 3.33%, T3 increased in 13.33% and T4 increased in 13.33%. Ultrasound findings of 26.66% patients were positive for PCOD. Adult acne is predominant in females as compared to adolescent acne, with grade II acne being more predominant, the role of hormones in adult acne has yet to show its co-relation with the disease. Studies looking into end organ sensitivity would further help in understanding role of hormones in adult acne.