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Prepubertal acne: a cutaneous marker of androgen excess?
L De Raeve1, J De Schepper, J Smitz
1Department of Dermatology, Free University of Brussels, Belgium.
Background:
Early-onset acne before obvious signs of puberty is an uncommon phenomenon.
Objective:
The aim of this study was to determine if prepubertal acne is associated with an excess of androgens.
Methods:
Basal and adrenocorticotrophic hormone-stimulated plasma androgen levels were measured and bone age was determined in 15 children with early-onset acne.
Results:
A late-onset adrenogenital syndrome caused by 21-hydroxylase deficiency was diagnosed in two children. These children had early pubic hair development and advanced bone maturation. Heterozygosity for 21-hydroxylase deficiency was found in three other children.
Conclusion:
We recommend hormonal evaluation in children with prepubertal acne, especially those with associated advanced bone maturation and early pubarche.