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Testosterone to estrogen ratio to assess hormonal imbalance in females with severe acne vulgaris

Megha K.Arora, Shashi Seth, Surabhi Dayal, Aniljeet Singh Trehan, Mamta Seth

Objective: Acne vulgaris is one of the commonest skin condition affecting young adults. Androgens are thought to play a crucial role in the pathogenesis of acne but the levels are usually within normal limits so it is difficult to decide when to start hormonal treatment in these patients. So, we planned to calculate testosterone to estrogen ratio in these patients. Design and Methods: Case control study was performed in the 90 females with severe acne vulgaris with mean ± S.D of age 21.93 ± 0.46 years. Patients attending dermatology OPD were randomly selected. Serum testosterone and estrogen were measured and testosterone/ estrogen ratio was calculated. Their results were compared with a group of 90 age matched healthy controls. Results: Mean ± SD of testosterone/ estrogen in the patients was significantly high as compared to controls. Area under receiver operating characteristic curve was 0.899 which suggests that this ratio can be used to evaluate risk of hormone imbalance in patients with severe acne vulgaris. At testosterone to estrogen ratio of 0.32 specificity was 0.889 and sensitivity was 0.891. Conclusion: The ratio can be used as a screening test to assess hormonal imbalance in females with severe acne vulgaris.