A 24-year-old woman presents with severe acne and irregular periods. What differential diagnosis should be investigated?

The situation describes a 24-year-old woman who is experiencing severe acne and irregular menstrual cycles, which raises the suspicion of hormonal imbalance. In this context, polycystic ovarian syndrome (PCOS) is a key differential diagnosis to consider.

PCOS is a common endocrine disorder in women of reproductive age, characterized by a combination of symptoms that can include irregular menstrual periods, hyperandrogenism (which manifests as acne and hirsutism), and polycystic ovaries. The presence of severe acne suggests elevated androgen levels, which are often associated with PCOS. The irregularities in the menstrual cycle further support this diagnosis, as women with PCOS frequently experience anovulation leading to irregular periods.

Investigating PCOS is crucial not only to confirm the diagnosis but also to manage the associated risks such as metabolic syndrome, type 2 diabetes, and cardiovascular disease. Other conditions like diabetes or adrenal gland cancer can also cause similar symptoms; however, they are less common in the 24-year-old demographic and often present with additional distinct signs and symptoms.

In summary, given the combination of severe acne and irregular periods, PCOS should be prioritized in the differential diagnosis to ensure appropriate management of this potentially debilitating condition.