Abstract
Androgen excess may have a profound effect on the skin, soma, and psyche of our patients [1]. The role of adrenal androgens in the development of acne is well known and the severity of early acne has been shown to correlate well with pubertal maturation (adrenarche and testis maturation) in young adolescent boys [2]. Although in women acne may present with other signs of hyperandrogenism, such as hirsutism or menstrual irregularities, in men acne may be the only sign of androgen excess. Congenital adrenal hyperplasia (CAH, MIM 201910) represents one of the causes of androgen excess, which, in turn, may cause or exacerbate acne via increased seborrhea [3].
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Heymann WR. Hyperandrogenism and the skin. J Am Acad Dermatol. 2003;50:937–8.
Lucky AW, Biro FM, Huster GA, et al. Acne vulgaris in early adolescent boys. Arch Dermatol. 1991;127:210–6.
Placzek M, Arnold B, Schmidt H, et al. Elevated 17-hydroxyprogesterone serum values in male patients with acne. J Am Acad Dermatol. 2005;53:955–8.
Arlt W, Krone N. Adult consequences of congenital adrenal hyperplasia. Horm Res. 2007;68 Suppl 5:158–64.
White PC, Speiser PW. Congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Endocr Rev. 2000;21:245–91.
Trakakis E, Laggas D. Salamalekis et al. 21-hydroxylase deficiency: From molecular genetics to clinical presentation. J Endocrinol Invest. 2005;28:187–92.
Levine LS, Zachmann M, New MI, et al. Genetic mapping of the 21-hydroxylase-deficiency gene within the HLA linkage group. N Engl J Med. 1978;299:911–5.
Speiser PW, White PC. Congenital adrenal hyperplasia. N Engl J Med. 2003;349:776–88.
Bachelot A, Chakthoura Z, Rouxel A, et al. Classical forms of congenital adrenal hyperplasia due to 21-hydroxylase deficiency in adults. Horm Res. 2008;69:203–11.
Azziz R, Rafi A, Smith BR, et al. On the origin of the elevated 17-hydroxyprogensterone levels after adrenal stimulation in hyperandrogenism. J Clin Endocrinol Metab. 1990;70:431–6.
Blanché H, Vexiau P, Clauin S, et al. Exhaustive screening of the 21-hydroxylase gene in a population of hyperandrogenic women. Hum Genet. 1997;101:56–60.
Speiser PW. Congenital adrenal hyperplasia owing to 21-hydroxylase deficiency. Endorinol Metab Clin North Am. 2001;30:31–59.
Wedell A, Ritzén EM, Haglund-Stengler B, et al. Steroid 21-hydroxylase deficiency: three additional mutated alleles and establishment of phenotype-genotype relationships of common mutations. Proc Natl Acad Sci U S A. 1992;89:7232–6.
Nikoshkov A, Ljic S, Holst M, et al. Synergistic effect of partially inactivating mutations in stroid 21-hydroxylase deficiency. J Clin Endocrinol Metab. 1997;82:194–9.
Owerbach D, Sherman L, Ballard AL, et al. Pro453 to Ser mutation in CYP21 is associated with nonclassic steroid 21-hydroxylase deficiency. Mol Endocrinol. 1992;6:1211–15.
Merke DP, Bornstein SR. Congenital adrenal hyperplasia. Lancet. 2005;365:2125–36.
Speiser PW, Dupont B, Rubinstein P, et al. High frequency of nonclassical steroid 21-hydroxylase deficiency. Am J Hum Genet. 1985;37:650–67.
Degitz K, Placzek M, Arnold B, et al. Congenital adrenal hyperplasia nd acne in male patiens. Br J Dermatol. 2003;148:1263–6.
Chrousos GP, Loriaux DL, Mann DL, et al. Late onset 21-hydroxylase deficiency mimicking idiopathic hirsutism or polycystic ovarian disease. Ann Intern Med. 1982;96:43–8.
Kuttenn F, Couillin P, Girard F, et al. Late-onset hyperplasia in hirsutism. N Engl J Med. 1985;313:224–31.
Moran C, Azziz R, Carmina E, et al. 21-hydroxylase-deficient nonclassic adrenal hyperplasia is a progressive disorder: A multicenter study. Am J Obstet Gynecol. 2000;183:1468–74.
New MI. Extensive clinical experience: nonclassical 21-hydroxylase deficiency. J Clin Endocrinol Metab. 2006;91:4205–14.
Speiser PW, Serrat J, New MI, et al. Insulin insensitivity in adrenal hyperplasia due to non classical steroid 21-hydroxylase deficiency. J Clin Endocrinol Metab. 1992;75:1421–4.
New MI. An update of congenital adrenal hyperplasia. Ann N Y Acad Sci. 2004;1038:14–43.
Conway GS. Congenital adrenal hyperplasia: Adolescence and transition. Horm Res. 2007;68 Suppl 5:155–7.
Tajima T, Fujieda K, Nakae J, et al. Molecular basis of nonclassical steroid 21-hydroxylase deficiency detected by neonatal mass screening in Japan. J Clin Endocrinol Metab. 1997;82:2350–6.
Trakakis E, Rizos D, Loghis C, et al. The prevalence of non-classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency in Greek women with hirsutism and polycystic ovary syndrome. Endocr J. 2008;55:33–9.
Kelestimur F. Non-classic congenital adrenal hyperplasia. Pediatr Endorcinol Rev. 2006;3 Suppl 3:451–4.
Lucky A, Rosenfield R, McGuine J, et al. Adrenal androgen hypperresponsiveness to adrenocorticotropin in women with acne and/or hirsutism: adrenal enzyme defects and exaggerated adrenarche. J Clin Endocrinol Metab. 1986;62:840–8.
Marynick S, Chakmakjian Z, McCaffree D, et al. Androgen excess in cystic acne. N Engl J Med. 1983;308:981–6.
Ostlere LS, Rumsby G, Holownia P, et al. Carrier status for steroid 21-hydroxylase deficiency is only one factor in the variable phenotype of acne. Clin Endocrinol (Oxf). 1998;48:209–15.
Kater CE, Biglieri EG, Wajchenberg B. Effects of continued adrenocorticotropin stimulation on the nimeralocorticoid hormones in classical and nonclassical simple virilizing types of 21-hydroxylase deficiency. J Clin Endocrinol Metab. 1985;60:1057–62.
Paczek M, Degitz K, Schmidt H, et al. Acne fulminans in late-onset congenital adrenal hyperplasia. Lancet. 1999;354:739–40.
Palatsi R, Reinilam M, Kivinen S, et al. Pituitary function and DHEA-S in male acne and DHEA-S, prolactin and cortisol before and after oral contraceptive treatment in female acne. Acta Derm Venereol. 1986;66:225–30.
Ramsay B, Alaghband Zadeh J, Carter G, et al. Raised serum 11-deoxycortisol in men with persistent acne vulgaris. Clin Endocrinol (Oxf). 1995;43:305–10.
Thiboutot D, Strauss J. Diseases of the sebaceous glands. In: Freedber IM, Eisen AZ, Wolff K, et al., editors. Fitzpatrick’s dermatology in general medicine. 6th ed. New York, NY: McGraw-Hill; 2003. p. 673–84.
Gollnick H, Cunliffe W, Berson D, et al. Management of acne. J Am Acad Dermatol. 2003;49:S20–25.
Thiboutot D. Acne: hormonal concepts. Clin Dermatol. 2004;22:419–28.
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Dessinioti, C., Katsambas, A.D. (2014). Congenital Adrenal Hyperplasia and Acne in the Male Patients. In: Zouboulis, C., Katsambas, A., Kligman, A. (eds) Pathogenesis and Treatment of Acne and Rosacea. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69375-8_31
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DOI: https://doi.org/10.1007/978-3-540-69375-8_31
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