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Congenital Adrenal Hyperplasia and Acne in the Male Patients

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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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References

  1. Heymann WR. Hyperandrogenism and the skin. J Am Acad Dermatol. 2003;50:937–8.

    Article  Google Scholar 

  2. Lucky AW, Biro FM, Huster GA, et al. Acne vulgaris in early adolescent boys. Arch Dermatol. 1991;127:210–6.

    Article  CAS  PubMed  Google Scholar 

  3. 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.

    Article  PubMed  Google Scholar 

  4. Arlt W, Krone N. Adult consequences of congenital adrenal hyperplasia. Horm Res. 2007;68 Suppl 5:158–64.

    Article  PubMed  Google Scholar 

  5. White PC, Speiser PW. Congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Endocr Rev. 2000;21:245–91.

    CAS  PubMed  Google Scholar 

  6. Trakakis E, Laggas D. Salamalekis et al. 21-hydroxylase deficiency: From molecular genetics to clinical presentation. J Endocrinol Invest. 2005;28:187–92.

    Article  CAS  PubMed  Google Scholar 

  7. 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.

    Article  CAS  PubMed  Google Scholar 

  8. Speiser PW, White PC. Congenital adrenal hyperplasia. N Engl J Med. 2003;349:776–88.

    Article  CAS  PubMed  Google Scholar 

  9. 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.

    Article  CAS  PubMed  Google Scholar 

  10. 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.

    Article  CAS  PubMed  Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. Speiser PW. Congenital adrenal hyperplasia owing to 21-hydroxylase deficiency. Endorinol Metab Clin North Am. 2001;30:31–59.

    Article  CAS  Google Scholar 

  13. 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.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. 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.

    CAS  PubMed  Google Scholar 

  15. 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.

    CAS  PubMed  Google Scholar 

  16. Merke DP, Bornstein SR. Congenital adrenal hyperplasia. Lancet. 2005;365:2125–36.

    Article  PubMed  Google Scholar 

  17. Speiser PW, Dupont B, Rubinstein P, et al. High frequency of nonclassical steroid 21-hydroxylase deficiency. Am J Hum Genet. 1985;37:650–67.

    PubMed Central  CAS  PubMed  Google Scholar 

  18. Degitz K, Placzek M, Arnold B, et al. Congenital adrenal hyperplasia nd acne in male patiens. Br J Dermatol. 2003;148:1263–6.

    Article  CAS  PubMed  Google Scholar 

  19. 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.

    Article  Google Scholar 

  20. Kuttenn F, Couillin P, Girard F, et al. Late-onset hyperplasia in hirsutism. N Engl J Med. 1985;313:224–31.

    Article  CAS  PubMed  Google Scholar 

  21. 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.

    Article  CAS  PubMed  Google Scholar 

  22. New MI. Extensive clinical experience: nonclassical 21-hydroxylase deficiency. J Clin Endocrinol Metab. 2006;91:4205–14.

    Article  CAS  PubMed  Google Scholar 

  23. 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.

    CAS  PubMed  Google Scholar 

  24. New MI. An update of congenital adrenal hyperplasia. Ann N Y Acad Sci. 2004;1038:14–43.

    Article  CAS  PubMed  Google Scholar 

  25. Conway GS. Congenital adrenal hyperplasia: Adolescence and transition. Horm Res. 2007;68 Suppl 5:155–7.

    Article  PubMed  Google Scholar 

  26. 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.

    Article  CAS  PubMed  Google Scholar 

  27. 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.

    Article  CAS  PubMed  Google Scholar 

  28. Kelestimur F. Non-classic congenital adrenal hyperplasia. Pediatr Endorcinol Rev. 2006;3 Suppl 3:451–4.

    Google Scholar 

  29. 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.

    Article  CAS  PubMed  Google Scholar 

  30. Marynick S, Chakmakjian Z, McCaffree D, et al. Androgen excess in cystic acne. N Engl J Med. 1983;308:981–6.

    Article  CAS  PubMed  Google Scholar 

  31. 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.

    Article  CAS  Google Scholar 

  32. 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.

    Article  CAS  PubMed  Google Scholar 

  33. Paczek M, Degitz K, Schmidt H, et al. Acne fulminans in late-onset congenital adrenal hyperplasia. Lancet. 1999;354:739–40.

    Article  Google Scholar 

  34. 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.

    CAS  PubMed  Google Scholar 

  35. 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.

    Article  CAS  Google Scholar 

  36. 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.

    Google Scholar 

  37. Gollnick H, Cunliffe W, Berson D, et al. Management of acne. J Am Acad Dermatol. 2003;49:S20–25.

    Article  Google Scholar 

  38. Thiboutot D. Acne: hormonal concepts. Clin Dermatol. 2004;22:419–28.

    Article  PubMed  Google Scholar 

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Correspondence to Clio Dessinioti .

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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

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-69374-1

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