Cutaneous Manifestations of Endocrine Disorders

Abstract

Dermatologists may commonly see skin lesions that reflect an underlying endocrine disorder. Identifying the endocrinopathy is very important, so that patients can receive corrective rather than symptomatic treatment. Skin diseases with underlying endocrine pathology include: thyrotoxicosis; hypothyroidism; Cushing syndrome; Addison disease; acromegaly; hyperandrogenism; hypopituitarism; primary hyperparathyroidism; hypoparathyroidism; pseudohypoparathyroidism and manifestations of diabetes mellitus. Thyrotoxicosis may lead to multiple cutaneous manifestations, including hair loss, pretibial myxedema, onycholysis and acropachy. In patients with hypothyroidism, there is hair loss, the skin is cold and pale, with myxedematous changes, mainly in the hands and in the periorbital region. The striking features of Cushing syndrome are centripetal obesity, moon facies, buffalo hump, supraclavicular fat pads, and abdominal striae. In Addison disease, the skin is hyperpigmented, mostly on the face, neck and back of the hands. Virtually all patients with acromegaly have acral and soft tissue overgrowth, with characteristic findings, like macrognathia and enlarged hands and feet. The skin is thickened, and facial features are coarser. Conditions leading to hyperandrogenism in females present as acne, hirsutism and signs of virilization (temporal balding, clitoromegaly).A prominent feature of hypopituitarism is a pallor of the skin with a yellowish tinge. The skin is also thinner, resulting in fine wrinkling around the eyes and mouth, making the patient look older. Primary hyperparathyroidism is rarely associated with pruritus and chronic urticaria. In hypoparathyroidism, the skin is dry, scaly and puffy. Nails become brittle and hair is coarse and sparse. Pseudohypoparathyroidism may have a special somatic phenotype known as Albright osteodystrophy. This consists of short stature, short neck, brachydactyly and subcutaneous calcifications. Some of the cutaneous manifestations of diabetes mellitus include necrobiosis lipoidica diabeticorum, diabetic dermopathy, scleredema adultorum and acanthosis nigricans.

Brittle Diabetes: A Contemporary Review of the Myth and Its Realization

“…This may result in spastic quadraparesis and permanent disability (Dixon et al, 2006). Some of the cutaneous manifestations of brittle diabetes include necrobiosis lipoidica diabeticorum, diabetic dermopathy, scleredema adultorum and acanthosis nigricans (Jabbour, 2003).…”

Você conhece esta síndrome?

“…1 As alterações endócrinas mais comumente associadas são o pseudo-hipoparatireoidismo, hipotireoidismo e hipogonadismo. Os portadores da síndrome podem ainda apresentar catarata, defeitos dentários, retardo mental e calcificação dos gânglios da base.…”

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Implantable Pump Therapy Restores Metabolic Control and Quality of Life in Type 1 Diabetic Patients With Buschke’s Nonsystemic Scleroderma

“…While diabetes is rarely associated, subcutaneous insulin treatment may be hardly feasible and effective because of incomplete absorption of insulin (1).…”

“…The Medicines and Healthcare Products Regulatory Agency (MHRA; executive agency of the Department of Health in the U.K., which enhances and safeguards the health of the public by ensuring the effectiveness of medicines and medical devices) has received a significant number of reports concerning difficulties in the operation and use of the OptiPen Pro-1 insulin pen injection system. A fault was found with some batches of the OptiPen Pro-1 system, whereby the dosage button failed to engage at the end of an injection (1).…”