Excretion of Estrin in Acne

Abstract

On clinical grounds it has long been suspected that acne vulgaris is caused by some endocrine disturbance—presumably by disturbance of the gonads (Pick, 1 Hollander, 2 Schamberg, 3 Darier, 4 Bloch, 5 Stein, 6 and others). The appearance of acne usually coincides with the endocrine changes for the sexual maturity associated with puberty. Only in exceptional instances is there any evidence that these changes are abnormal as for example, the case cited by Bloch in which acne appeared in the first years of life when (owing to suprarenal tumor) sexual maturity was precociously developed.

It seemed to the writers that evidence of normality would be tested by a study of the excretion of estrin and prolan in women with acne. Previous studies 7 have shown that normal women between the ages of sex maturity and the menopause excrete from 10 to 20 rat units of estrin per liter of urine throughout the menstrual cycle. Prolan is not found by the methods here employed in such cases.

The urines of 34 young women who applied to Vanderbilt Clinic for treatment of acne were examined. The age range was 11 to 33 years, 21 being under 20 years of age. Estrin was determined by the method of Kurzrok and Ratner, 8 and prolan by the method of Zondek. 9

Ovarian hormone was completely absent in 27 of these cases, present in normal amounts (10-20 rat units) in 6 cases, and slightly positive in one case (4 rat units).

Work has not progressed to a stage from which final conclusions can be drawn, and the results of treatment with preparations of ovarian follicular hormone and anterior pituitary prohormone will be reported later, but a number of patients who formerly excreted no hormone were found to be excreting hormone after treatment.