Correlations between acne and polycystic ovary. A study of 60 cases

BACKGROUND: In this paper we correlated the clinical severity of the polycystic ovary with the clinical manifestation of acne. Acne is an inflammatory process of follicle sebaceous unites. Polycystic ovaries (PCOS) are characterized by several subcapsular cystic follicles with an increased production of androgens. Onset of polycystic ovaries in women with acne, ranges from 45 to 84% of cases. METHODS: Sixty patients, aged from 19 to 28 years, with acne and polycystic ovaries were enrolled. The clinical severity of acne was appraised by millimetric macrophotography. This technique evaluated subsequent phases of acne like comedo, papules or pustules, nodular or scarring lesions. Polycystic ovaries were studied by ultrasound and hormonal assay. Sonora Logic 500 MD, by GE Echography, with 3.5 MHz convex probe, were employed. US examination was performed, in each patient, on day 6th, 10th, 15th and 22th of the menstrual cycle. The following US parameters were considered: dimension of the ovaries, thickness of albuginea and number of cysts. Serum levels of FSH, LH, 17-b-estradiol, progesterone, DHEA-S, testosterone and LH/FSH ratio were determined. Furthermore, the presence of premenstrual syndrome (PMS) was evaluated. RESULTS: We found that in PCOS the increased levels of androgens can cause the onset of acne. Photographic score and ovaries ultrasonography may be useful in the assessment of the clinical association between acne and polycystic ovaries. We observed that the subsequent phases of acne were correlated with the clinical severity of polycystic ovaries and to the presence of Premenstrual Syndrome in 93% of the cases (56 of 60 patients). CONCLUSIONS: US images, compared with visual score, established the clinical association between acne and PCOS in three phases with a progressive severity.