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Physicians should be suspicious of underlying systemic disease processes in patients of this age who present with onset of acne lesions, as pre\u2010pubertal acne in childhood has a distinctly different pathology than that of other age groups. Through a case series, we highlight the importance of a thorough work\u2010up and provide a review on when to refer to pediatric endocrinology to rule out precocious puberty and tumors as the cause of pre\u2010pubertal acne.<\/jats:p>","DOI":"10.1111\/pde.15166","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T03:04:54Z","timestamp":1668654294000},"page":"5-10","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pathologic acne in pre\u2010pubertal children: A case series and review on when to refer to pediatric endocrinology"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2944-4380","authenticated-orcid":false,"given":"Chelsea","family":"Shope","sequence":"first","affiliation":[{"name":"College of Medicine Medical University of South Carolina  Charleston South Carolina 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