Abstract
Introduction: Polycystic ovary syndrome (PCOS) is the leading endocrine disorder in young women of childbearing age. Dermatological issues, particularly acne, are a major reason for medical consultations. This study seeks to establish the prevalence of PCOS among patients with acne and to compare the metabolic and hormonal clinical characteristics of acne patients with PCOS to those with isolated acne. Patients and Methods: This was a prospective study conducted with analytical objectives at the Endocrinology Department and Dermatology Department of CHU Farhat Hached Sousse. The study included patients seeking treatment for acne from January 2023 to January 2024, divided into two groups: those with confirmed PCOS (G1) and those with isolated acne (G2). All patients underwent hormonal assessment and ovarian ultrasound. Results: We conducted a study involving 212 patients. We found that 65.6% of acne patients had been diagnosed with PCOS. Nodular lesions were significantly more frequent in G1 (p = 0.02). Acne was linked with hirsutism, which was more prevalent in G1 (94.2% G1 vs. 67.1% G2), as well as androgenic alopecia (51% G1 vs. 21.9% G2) (p < 10− 3). G1 showed evidence of biological hyperandrogenism, with a mean testosterone level of 0.72 ± 0.27 ng/mL, significantly higher than in G2. The LH/FSH ratio was greater than 1 in 72.7% of G1 cases, with a notable difference from G2. In our study, acne in G1 appeared to be more severe and was associated with hypertestosteronemia (p = 0.041) and hyperprolactinemia (p = 0.008). According to our results, phenotype A was the most likely to cause severe acne (p = 0.043). Conclusion: Our work is unique in that it brings to light this hidden aspect of the dermatological impact of PCOS, prompting physicians to screen for this endocrine disorder in all adult women seeking acne treatment.