Functioning pituitary tumours: Hints from the skin

Abstract

We introduce dermatological aspects from an endocrine point of view related to pituitary tumours that display active secretor activity. This is a short literature review. 40 papers are cited including narrative reviews and original studies. Acromegaly: GH overproduction causes the thickening of the skin and swelling of the soft tissues in addition to the enlargement of extremities (like nose, hands, feet, jaw), coarsening of facial features (as front head and naso-labial folds), excessive sweating, exaggerate skin wrinkles, oily skin, and acrochordons. Cushing's disease: cortisol overproduction has a severe protein catabolic effect at skin with collagen network disruption while immune effect of hypercortisolemia induces chronic skin infections and difficulties in wound healing. In females, consecutive androgens excess induces acne, hirsutism, and androgens-related alopecia. The classical phenotype includes: fragile skin or skin atrophy, red/purple striae, easy bruising, facial plethora. Skin changes represent the window to pituitary tumours for clinicians of different specialities, therefore contributing to final diagnosis of endocrinopathies.

Approach of Multiple Endocrine Neoplasia Type 1 (MEN1) Syndrome–Related Skin Tumors

“…We still do not know enough with respect to particular endocrine configuration concerning the subgroup of MEN1 individuals with skin findings and whether the relationship is in terms of skin issues influencing the endocrine evolution or quite the other way around. From a dermatologic perspective, differential diagnosis of angiofibromas, collagenomas, and lipomas should include other genetic syndromes (mostly genodermatoses like Birt-Hogg-Dubé, tuberous sclerosis, and Cowden Syndrome since skin is a strong player) in addition to different clinical endocrine and non-endocrine entities due to multiple gene anomalies [ 115 , 116 , 117 , 118 , 119 , 120 ]. It is also worth mentioning that sometimes, even though a number of cutaneous tumors typically associated with genodermatosis are present in the same patient, the occurrence might be coincidental according to current knowledge.…”