Acne in setting of endocrine abnormality

Question 1

What are causes of Acne due to an endocrinologic abnormality?

Answer 1

• PCOS
• Congenital adrenal hyperplasia
• Androgen-secreting tumors and cushings syndrome

Question 2

Initial workup when suspecting endocrinologic cause of acne:

Answer 2

• total/free testosterone
• DHEAS
• LH/FSH
• can also consider 17-hydroxyprogesterone, prolactin, morning cortisol, and ACTH stimulation test

Question 3

Females with increased total testosterone and acne indicates the source is:

Answer 3

ovarian

• PCOS has increased testosterone and increased LH/FSH ratio
• ovarian tumors have increased total testosterone

Question 4

acne caused by increased DHEAS or 17-hydroxyprogesterone indicates the source is:

Answer 4

adrenal

• congenital adrenal hyperplasia (defects in 21-hydroxylase or 11-hydroxylase)
• adrenal tumors have high DHEAS
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