To the Editor.—
The great interest recently aroused by the use of antiandrogens in dermatology1 prompts us to report the preliminary results that we obtained using a new antiandrogen, ketoconazole, in the treatment of acne and hirsutism in women. Ketoconazole, an oral imidazole antifungal drug, is a potent inhibitor of testosterone synthesis that has been recently used to induce and maintain a remission in patients with advanced prostatic cancer.2,3 In the last few months, we have used oral ketoconazole in the treatment of three female patients affected by severe acne and hirsutism.At the start of therapy, serum total testosterone levels were raised in all three patients, ranging from 1.12 to 1.54 ng/mL (normal, 0.36 to 0.80 in women and 2.58 to 7.78 in men). Ketoconazole was administered at the dosage of 300 mg twice daily for three months. No topical therapy was added. All three patients experienced