RESUMEN
CONTEXT: Sebaceous gland hypertrophy (SGH) and acne-like skin eruptions are frequent during the first months of life, yet the etiology and prevalence of these conditions in infants are not clear. OBJECTIVE: The objective of the study was to evaluate the association of postnatal androgens with SGH and acne in infants. DESIGN: This was a longitudinal, monthly follow-up from 1 wk (D7) to 6 months of age (M1-M6). PATIENTS: Patients included 54 full-term (FT; 26 boys) and 48 preterm (PT; gestational age at birth 27.7-36.6 wk, 22 boys) infants. MAIN OUTCOME MEASURES: The occurrence of SGH (present/absent) and acne (5-10, 10-50, and >50 papules) was registered and compared with urinary levels of dehydroepiandrosterone and its sulphate and testosterone measured by liquid chromatography-tandem mass spectrometry. RESULTS: SGH was observed in 89% of FT and 96% of PT infants (P = 0.28). Acne (more than five papules) was observed in 91% of FT infants and in 75% of PT infants (P = 0.06). Both SGH and acne were associated with developmental rather than calendar age: SGH was limited to postmenstrual age less than 46 wk and acne was not observed less than 37 wk of postmenstrual age. Urinary androgen levels showed severalfold differences in magnitude between sexes and between the FT and PT groups. After grouping according to sex and maturity, the occurrence of SGH and the severity of acne were associated with higher urinary dehydroepiandrosterone sulphate and testosterone levels in each group. CONCLUSIONS: SGH and acne are common during the first months of life and associated with endogenous, physiologically elevated levels of androgens originating from the adrenals and gonads. These data suggest a novel role for postnatal androgen secretion in infancy.
Asunto(s)
Acné Vulgar/etiología , Andrógenos/metabolismo , Enfermedades de las Glándulas Sebáceas/etiología , Glándulas Sebáceas/patología , Acné Vulgar/congénito , Acné Vulgar/metabolismo , Acné Vulgar/orina , Andrógenos/orina , Estudios de Cohortes , Sulfato de Deshidroepiandrosterona/orina , Femenino , Edad Gestacional , Humanos , Hipertrofia , Recién Nacido/metabolismo , Recién Nacido/orina , Enfermedades del Recién Nacido/etiología , Enfermedades del Recién Nacido/metabolismo , Enfermedades del Recién Nacido/orina , Enfermedades del Prematuro/etiología , Enfermedades del Prematuro/metabolismo , Enfermedades del Prematuro/orina , Estudios Longitudinales , Masculino , Enfermedades de las Glándulas Sebáceas/congénito , Enfermedades de las Glándulas Sebáceas/metabolismo , Enfermedades de las Glándulas Sebáceas/orina , Glándulas Sebáceas/metabolismo , Testosterona/orina , Factores de Tiempo , UrinálisisRESUMEN
Acne may be the only clinical sign of androgen excess in men. We report a boy with acne fulminans and androgen excess due to late-onset congenital adrenal hyperplasia.
Asunto(s)
Acné Vulgar/congénito , Hiperplasia Suprarrenal Congénita/diagnóstico , Acné Vulgar/tratamiento farmacológico , Adolescente , Hiperplasia Suprarrenal Congénita/tratamiento farmacológico , Esquema de Medicación , Quimioterapia Combinada , Humanos , Isotretinoína/administración & dosificación , Masculino , Metilprednisolona/administración & dosificaciónAsunto(s)
Membrana Mucosa/anomalías , Anomalías Cutáneas , Enfermedades de la Piel/congénito , Acné Vulgar/congénito , Acné Vulgar/diagnóstico , Adulto , Factores de Edad , Diagnóstico Diferencial , Quiste Epidérmico/congénito , Quiste Epidérmico/diagnóstico , Femenino , Estudios de Seguimiento , Dermatosis del Pie/congénito , Dermatosis del Pie/diagnóstico , Dermatosis de la Mano/congénito , Dermatosis de la Mano/diagnóstico , Hemangioma/congénito , Hemangioma/diagnóstico , Humanos , Recién Nacido , Leucoedema Bucal/congénito , Leucoedema Bucal/diagnóstico , Masculino , Quistes Odontogénicos/congénito , Quistes Odontogénicos/diagnóstico , Trastornos de la Pigmentación/congénito , Trastornos de la Pigmentación/diagnóstico , Anomalías Cutáneas/diagnóstico , Enfermedades de la Piel/diagnóstico , Enfermedades Cutáneas Vasculares/congénito , Enfermedades Cutáneas Vasculares/diagnóstico , Neoplasias Cutáneas/congénito , Neoplasias Cutáneas/diagnóstico , Hidrocele Testicular/congénito , Hidrocele Testicular/diagnóstico , Factores de TiempoRESUMEN
We report on three patients with black or white comedones arranged along the nasal groove in the distal third of the nose between the alar and triangular cartilages. This peculiar disorder is probably more common than would appear from the small number of cases so far reported in the literature.