Acne Vulgaris- Associated Cutaneous Findings, PCOS and Hormonal Changes

Acne vulgaris is a common skin condition which can present as a part of metabolic syndrome called polycystic ovarian syndrome(PCOS). This study was done to determine the associated cutaneous findings in acne, its association with PCOS and the hormonal changes in acne vulgaris. A prospective study was done on 50 female patients who presented with acne. Presence of associated clinical manifestations like Hirsutism, Acanthosis nigricans, Menstrual Dysfunction and Androgenetic Alopecia were noted. Pelvic Ultrasonography of the pelvis was done to look for Polycystic Ovaries. Hormonal Investigations done were Serum Dehydroepiandrosteronesulfate (DHEAS) levels, Serum Follicle stimulating hormone (FSH) levels, Serum Leuteinizing hormone (LH) levels, Serum Prolactin levels, Serum Testosterone and Serum Insulin levels. In our study,14% patients demonstrated Acanthosis nigricans, 24% had menstrual dysfunction and 12 % had Androgenetiic alopecia. PCOD was seen in 44% patients on ultrasonography. LH/FSH ratio was deranged in 12 % patients, raised serum insulin levels were seen in 12% cases, raised levels of Dehydroepiandrosterone sulphate(DHEAS) was seen in 12 % patients and raised Prolactin levels were seen in 8 % of the cases and 2% demonstrated raised testosterone levels. Patients with acne vulgaris may show clinical features like Acanthosis nigricans, androgenetic alopecia and hirsutism. A major group may show underlying PCOD and hormonal derangements. Hence, all female patients with acne should be screened with Ultrasonography and hormonal studies for optimal management.