Skin Problems according to Gender

Gender aspects in skin diseases.

Chen W, Mempel M, Traidl-Hofmann C, Al Khusaei S, Ring J.

J Eur Acad Dermatol Venereol. 2010 Dec;24(12):1378-85.

We chose this article because it shows tables with sexual predominance for skin conditions (these are based on articles existing in the scientific literature). For example Dermatofibroma is more than 9 times more likely in females than in males. Conditions such as Rhinophyma and Kaposi’s sarcoma are more than 9 times more likely in males than in females.

It also shows how incoherences are still taught and entrenched in the dermatologist’s psyche:

-Chronic actinic dermatitis (actinic reticuloid) is only 2 to 4 times more likely in males.

-Acne fulminans and Perifollliculitis capitis abscedens et suffodiens (dissecting cellulitis of the scalp) (Hoffman’s disease) are more than 9 times more likely in males than females. These are two pillars of the tetrad of follicular obstruction syndrome (acne inversa), the 2 others are Hidradenitis Suppurative (Verneuil’s Disease) and Pilonodal cysts of the buttock region.

Hidradenitis Suppurativa (Verneuil’s disease) is not mentioned in this article. Some advocate a female preponderence (due to hormonal factors: the condition tends to start from puberty and quiet down around menopause even if androgen levels* (male hormones) are normal). Others say that the prevalence is the same for both sexes.

Therefore there is a problem in putting Verneuil’s disease in this article and it isn’t mentioned why. We believe it could have been omitted because it would anihilate the follicular occlusion theory (which dates from the sixties) and challenge our certainties. “Smoking acting as a promoter to *androgen action”: why would the condition not be preponderent in men?

True the strength of the sexual ratios depends on geographical factors and study designs. We believe it is not always indicated to compare apples and oranges. But this synopsis points in the right direction that we need to adapt ourselves to the perpetual novelties of medical science and  keep our minds open to welcome them.