Skin Tensile Properties in Patients Treated for Acromegaly

Abstract

Background: Somatotropic effects are described in the skin. Indeed, acromegaly is in part clinically recognized by cutaneous coarsening. The actual changes in tensile properties associated with the cutaneous manifestations are largely unknown. Objectives: To study the relationships between the skin tensile properties and the severity of acromegaly as assessed by serum levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). Patients and Method: Assessments were made in 13 patients with acromegaly treated by somatostatin agonists combined or not with surgery. A total of 39 age- and sex-matched healthy subjects served as controls. Skin tensile properties were measured on the forearm and nape of the neck using a computerized suction device. Results: Significant differences were yielded between the skin tensile properties in patients and normal subjects. The highest IGF-1 values in the patients’ medical records were positively correlated with both skin distensibility and biologic elasticity. The most recent IGF-1 serum levels were negatively correlated with the visco-elastic ratio. No correlations were yielded between any of the biomechanical parameters and GH levels, disease duration and treatment dosages, respectively. Conclusion: The skin in acromegaly appears to be functionally more redundant and elastic than normal skin. The biomechanical changes appear quite different from those observed in other diseases with collagen deposition such as diabetes mellitus and scleroderma.

The effects of severe growth hormone deficiency on the skin of patients with Sheehan's syndrome

“…Castration of these mice prevents the increase in skin thickness and thus confirms a role for synergy between GH and androgens in skin growth 28 . The observed effects of GH on skin thickness, and in some cases mechanical strength, are primarily due to an increase in collagen content in the dermis and are not due to epidermal expansion 29 . GH can bind to cultured human fibroblasts, through GH receptors, and elicit a proliferative response.…”

Skin in maturity: the endocrine and neuroendocrine pathways

“…Diabetes mellitus and acromegaly are two typical examples [35][36][37][38][39][40][41][42]. However, all aspects of skin ageing are not boosted by these diseases.…”

“…Conversely, reduction of dermal thickness, decreased skin elasticity and, less frequently, easy ulcerations have been described in growth hormone deficiency [39]. In both pathological conditions, the normalization of altered circulating GH levels only determines a partial reversibility of the skin alterations [40].…”

Biophysical characteristics of skin in diabetes: a controlled study

“…The skin involvement in diabetes encompasses various clinical entities such as acanthosis nigricans, necrobiosis lipoidica, diabetic dermopathy and neuropathy, scleredema, and granuloma annulare 1 . It seems that diabetes, similar to some other endocrine disorders such as acromegaly, may cause some alterations in functional and mechanical properties of the skin 2 . All of these alterations could be derived from an impaired skin homeostasis caused by either diabetes induced abnormalities of the skin metabolism or diabetic complications such as vasculopathy and neuropathy.…”