Background: Early-onset acne before obvious signs of puberty is an uncommon phenomenon.
Objective: The aim of this study was to determine if prepubertal acne is associated with an excess of androgens.
Methods: Basal and adrenocorticotrophic hormone-stimulated plasma androgen levels were measured and bone age was determined in 15 children with early-onset acne.
Results: 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.
Conclusion: We recommend hormonal evaluation in children with prepubertal acne, especially those with associated advanced bone maturation and early pubarche.