Endocrine Abstracts

JOINT612

Introduction and Objective: Traditionally considered as an inflammatory skin disorder of adolescence, acne can also affect adults, especially women. This study aims to analyze the epidemiological and clinical data of acne in adult women and to screen for hormonal imbalances in this population.

Materials and Method: We conducted a retrospective study (January 2022 - December 2023), enrolling all women aged 25 years or older who presented with acne. The diagnosis of polycystic ovary syndrome (PCOS) was made according to the revised Rotterdam criteria (2003).

Results: We included 107 women, with a mean age of 29 years. The acne either persisted since adolescence (18.7%) or appeared after the age of 25, either de novo (68.2%) or as a recurrence (13.1%). It was inflammatory (40.2%), comedonal (18.7%), or mixed (41.1%). The lesions were located on the face (96.3%), neck (8%), chest (2.8%), and/or back (2.8%). Acne occurred in the context of hormonal imbalances in 31.8% of cases, including PCOS, which was suspected in 23 patients and confirmed in 16 cases (15%), hyperprolactinemia in 4 cases (3.7%), and hormonal contraception in 3 cases (2.8%) (hormonal intrauterine device, oral levonorgestrel, progestin implant). Acne was triggered or worsened by pregnancy in 3 cases and linked to the menstrual cycle in 1 case. Iatrogenic acne (8.4%) was induced by systemic (n = 2) or topical (n = 3) corticosteroids, azathioprine (n = 1), erlotinib (n = 1), teriflunomide (n = 1), and interferon beta (n = 1). Exogenous acne (40.2%) was induced by cosmetic products (20.6%), mask-wearing (maskne) (15.9%), and/or waxing (3.7%).

Conclusions: Our results are consistent with those of a Colombian study revealing a peak in late-onset acne among women aged 25 to 29 years. However, the prevalence of PCOS in our series is about half that of a Moroccan study (39% vs 15%). A lower demand for hormonal testing may explain this disparity. According to Dréno et al., adult female acne is predominantly mixed, but the involvement of the trunk is significantly less frequent in our study (48.4% vs 2.8%). Pregnancy can trigger or worsen acne due to global hypertestosteronemia. This condition may be attributed to an increase in Testosterone-Binding Globulin (TeBG) synthesis and elevated androstendione levels during pregnancy. Paroxysmal acneiform eruptions can be caused by glucocorticoids, androgens, halogens, lithium salts, vitamin B12, certain antidepressants, antiepileptics, immunosuppressants, and also epidermal growth factor receptor (EGFR) inhibitors. Comedogenic cosmetic products increases pore obstruction and bacterial proliferation.