Psychological and sympatho-adrenal status in patients with cystic acne

Background Patients with cystic acne (CA) frequently report feeling self conscious, anxiety and social isolation. Methods Mood characteristics as well as self-esteem scores of 38 patients with CA were evaluated before and after 30 days treatment with isotretinoin. A high pressure, liquid chromatography method was used for the evaluation of catecholamines (epinephrine (E) and nor-epinephrine (NE)) in the blood of the patients at the time of the study and in controls (n = 30) after their psychological testing. Moreover, E and NE were measured in the blood of eight healthy volunteers before and after 1 month 'treatment' with the drug. Results The CA subjects evidenced anxiety and high catecholamine plasma levels (E = 98.0 +/- 0.8 pg/ml, NE = 250.8 +/- 56.6 pg/ml) before treatment compared to controls (E = 71.8 +/- 23.0 pg/ml, NE = 190.0 +/- 52 pg/ml, P < 0.006), and these levels were lower (E = 75.4 +/- 21.4 pg/ml, NE = 202.0 +/- 49.9 pg/ml, P < 0.001) when their psychological status returned to normal after treatment. No differences were observed in E and NE levels in the eight healthy volunteers who received the same dose of the drug at the same time of study. Conclusions It is suggested that not only the psychological status is influenced in subjects with CA but also their sympathoadrenal system. (C) 1999 Elsevier Science B.V. All rights reserved.