Prepubertal acne: a cutaneous marker of androgen excess?

Abstract

Early-onset acne before obvious signs of puberty is an uncommon phenomenon. The aim of this study was to determine if prepubertal acne is associated with an excess of androgens. Basal and adrenocorticotrophic hormone-stimulated plasma androgen levels were measured and bone age was determined in 15 children with early-onset acne. A late-onset adrenogenital syndrome caused by 21-hydroxylase deficiency was diagnosed in two children. These children had early pubic hair development and advanced bone maturation. Heterozygosity for 21-hydroxylase deficiency was found in three other children. We recommend hormonal evaluation in children with prepubertal acne, especially those with associated advanced bone maturation and early pubarche.