ENDOCRINOLOGY OF ACNE AND THE PILOSEBACEOUS UNIT
DOI:
https://doi.org/10.29176/2590843X.1624Keywords:
Acne, Congenital adrenal hyperplasia, Cushing's syndrome, Polycystic ovary syndrome, Sebaceous glands, TestosteroneAbstract
Acne is a multifactorial disease with endocrine influences. The objective of this paper is to present the pathophysiological bases of acne and its interactions with the endocrine system. The importance of traditionally described hormones such as testosterone, dihydrotestosterone and insulin as trophic stimuli for the sebaceous gland are reviewed. This paper also explores the influence of other hormones traditionally less associated with acne such as cortisol, proopiomelanocortin, prolactin and growth hormone, that have proven to influence sebum secretion by the pilosebaceous unit. Finally, the interaction of these pathophysiological phenomena is described in entities such as polycystic ovary syndrome, congenital adrenal hyperplasia and Cushing syndrome.
Author Biographies
Laura Carolina Camacho-Pérez, Dermatóloga, Universidad Nacional de Colombia.
Dermatóloga, Universidad Nacional de Colombia.
Juan José Duque-Ramírez, Unidad de endocrinología, departamento de medicina interna, Universidad Nacional de Colombia.
Unidad de endocrinología, departamento de medicina interna, Universidad Nacional de Colombia.
Paola Hernández-Rúa, Médica General en Hospitalización, Hospital Pablo Tobón Uribe, Medellín
Médica General en Hospitalización, Hospital Pablo Tobón Uribe, Medellín
Héctor José Castellanos-Lorduy, Coordinador, programa curricular de Dermatología, departamento de medicina interna, Universidad Nacional de Colombia.
Coordinador, programa curricular de Dermatología, departamento de medicina interna, Universidad Nacional de Colombia.
Roberto Franco-Vega, Unidad de Endocrinología, departamento de medicina interna, Universidad Nacional de Colombia
Unidad de Endocrinología, departamento de medicina interna, Universidad Nacional de Colombia
References
Plewig G, Melnik B, Chen W. Pilosebaceous Follicles: Structure, Biochemistry, and Function. En: Plewig and Kligman´s Acne and Rosacea. Cham: Springer International Publishing; 2019. p. 1-34. Disponible en: https://bit.ly/2S7OW9k
Melnik BC. Acne vulgaris: The metabolic syndrome of the pilosebaceous follicle. Clin Dermatol. 2018;36(1):29-40. https://doi.org/10.1016/j.clindermatol.2017.09.006
Soyuduru G, Özsoy Adişen E, Kadioğlu Özer I, Aksakal AB. The effect of isotretinoin on insulin resistance and adipocytokine levels in acne vulgaris patients. Turkish J Med. 2019;49:238-44. Disponible en: https://bit.ly/3fUgiso
Bosanac SS, Trivedi M, Clark AK, Sivamani RK, Larsen LN. Progestins and acne vulgaris: A review. Dermatol Online J. 2018;24(5):1-6. Disponible en: https://bit.ly/2SXsobf
Bolognia J, Schaffer J, Lorenzo C. Dermatology. 4.a edición. Elsevier; 2017. p. 588-603.
Bienenfeld A, Azarchi S, Lo Sicco K, Marchbein S, Shapiro J, Nagler AR. Androgens in women: Androgen-mediated skin disease and patient evaluation. J Am Acad Dermatol. 2019;80(6):1497-506. https://doi.org/10.1016/j.jaad.2018.08.062
Alexis, Andrew F; Harper, J.C; Tan J. Acne and Rosacea: Applying Emerging Science to Improve Outcomes. Sem Cutan Med Surg. 2018;37:60-2. Disponible en: https://bit.ly/3uYpD6X
Schmidt TH, Shinkai K. Evidence-based approach to cutaneous hyperandrogenism in women. J Am Acad Dermatol. 2015;73(4):672-90. https://doi.org/10.1016/j.jaad.2015.05.026
Bagatin E, Freitas THP De, Rivitti-Machado MC, Ribeiro BM, Nunes S, Rocha MAD Da. Adult female acne: a guide to clinical practice. An Bras Dermatol. 2019;94(1):62-75. https://doi.org/10.1590/abd1806-4841.20198203
Franik G, Bizon A, Wloch S, Kowalczyk K, Biernacka-Bartnik A, Madej P. Hormonal and metabolic aspects of acne vulgaris in women with polycystic ovary syndrome. Eur Rev Med Pharmacol Sci. 2018;22(14):4411-8. https://doi.org/10.26355/eurrev_201807_15491
Kumtornrut C, Yamauchi T, Koike S, Aiba S, Yamasaki K. Androgens modulate keratinocyte differentiation indirectly through enhancing growth factor production from dermal fibroblasts. J Dermatol Sci. 2019;93(3):150-8. https://doi.org/10.1016/j.jdermsci.2019.01.007
Montoya de Bayona LS. La importancia de los andrógenos en el acné. MedUnab. 2002;5(14):100-8. Disponible en: https://bit.ly/3cmyoRz
Ju Q, Tao T, Hu T, Karadağ AS, Al-Khuzaei S, Chen W. Sex hormones and acne. Clin Dermatol. 2017;35(2):130-7. https://doi.org/10.1016/j.clindermatol.2016.10.004
Szöllösi A, Oláh A, Bíró T, Tóth B. Recent advances in the endocrinology of the sebaceous gland. Dermatoendocrinol. 2018;9(1):e1361576. http://doi.org/10.1080/19381980.2017.1361576
Acmaz G, Cınar L, Acmaz B, Aksoy H, Kafadar YT, Madendag Y, et al. The Effects of Oral Isotretinoin in Women with Acne and Polycystic Ovary Syn drome. Biomed Res Int. 2019;2019:1-5. https://doi.org/10.1155/2019/2513067
Dréno B, Bettoli V, Araviiskaia E, Sanchez Viera M, Bouloc A. The influence of exposome on acne. J Eur Acad Dermatology Venereol. 2018;32(5):812-9. https://doi.org/10.1111/jdv.14820
Hirt PA, Castillo DE, Yosipovitch G, Keri JE. Skin changes in the obese patient. J Am Acad Dermatol. 2019;81(5):1037-57. https://doi.org/10.1016/j.jaad.2018.12.070
Slominski A, Malarkey WB, Wortsman J, Asa SL, Carlson A. Human skin expresses growth hormone but not the prolactin gene. J Lab Clin Med. 2000;136(6):476-81. http://doi.org/10.1067/mlc.2000.110605
Oakes SR, Haynes KM, Waters MJ, Herington AC, Werther GA. Demonstration and localization of growth hormone receptor in human skin and skin fibroblasts. J Clin Endocrinol Metab. 1992;75(5):1368-73. http://doi.org/10.1210/jcem.75.5.1430099
Elsaie M. Hormonal treatment of acne vulgaris: an update. Clin Cosmet Investig Dermatol. 2016;9:241-8. https://doi.org/10.2147/CCID.S114830
Arora MK, Yadav A, Saini V. Role of hormones in acne vulgaris. Clin Biochem. 2011;44(13):1035-40. http://doi.org/10.1016/j.clinbiochem.2011.06.984
Langan EA, Hinde E, Paus R. Prolactin as a candidate sebotrop(h)ic hormone? Exp Dermatol. 2018;27(7):729-36. http://doi.org/10.1111/exd.13545
Clayton RW, Langan EA, Ansell DM, de Vos IJHM, Göbel K, Schneider MR, et al. Neuroendocrinology and neurobiology of sebaceous glands. Biol Rev. 2020;95(3):592-624. https://doi.org/10.1111/brv.12579
Zouboulis CC, Seltmann H, Hiroi N, Chen W, Young M, Oeff M, et al. Corticotropin-releasing hormone: An autocrine hormone that promotes lipogenesis in human sebocytes. Proc Natl Acad Sci. 2002;99(10):7148-53. http://doi.org/10.1073/pnas.102180999
Slominski A, Pisarchik A, Tobin DJ, Mazurkiewicz JE, Wortsman J. Differential Expression of a Cutaneous Corticotropin-Releasing Hormone System. Endocrinology. 2004;145(2):941-50. http://doi.org/10.1210/en.2003-0851
Zhang L, Anthonavage M, Huang Q, Li WH, Eisinger M. Proopiomelanocortin peptides and sebogenesis. Ann New York Acad Sci. 2003;994:154-61. http://doi.org/10.1111/j.1749-6632.2003.tb03175.x
Karadag AS, Takci Z, Ertugrul DT, Bilgili SG, Balahoroglu R, Takir M. The effect of different doses of isotretinoin on pituitary hormones. Dermatology. 2015;230(4):354-9. http://doi.org/10.1159/000375370
Melnik B. Isotretinoin and FoxO1. Dermatoendocrinol. 2011;3(3):141-65. https://doi.org/10.4161/derm.15331
Morris S, Grover S, Sabin MA. What does a diagnostic label of ‘polycystic ovary syndrome’ really mean in adolescence? a review of current practice recommendations. Clin Obes. 2016;6(1):1-18. http://doi.org/10.1111/cob.12123
Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Consensus on women’s health aspects of polycystic ovary syn drome (PCOS). Hum Reprod. 2012;27(1):14-24. http://doi.org/10.1093/humrep/der396
Witchel SF, Oberfield S, Rosenfield RL, Codner E, Bonny A, Ibáñez L, et al. The Diagnosis of Polycystic Ovary Syndrome during Adolescence. Horm Res Paediatr. 2015;83(6):376-89. http://doi.org/10.1159/000375530
Dumesic DA, Oberfield SE, Stener-Victorin E, Marshall JC, Laven JS, Legro RS. Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome. Endocr Rev. 2015;36(5):487-525. https://doi.org/10.1210/er.2015-1018
Housman E, Reynolds RV. Polycystic ovary syndrome: A review for dermatologists: Part I. Diagnosis and manifestations. J Am Acad Dermatol. 2014;71:847.e10. https://doi.org/10.1016/j.jaad.2014.05.007
Pace JL. Acne - a potential skin marker of internal disease. Clin Dermatol. 2015;33(5):572-8. https://doi.org/10.1016/j.clindermatol.2015.05.010
Feng J, Guo Y, Ma L, Xing J, Sun R, Zhu W. Prevalence of dermatologic manifestations and metabolic biomarkers in women with polycystic ovary syndrome in north China. J Cosmet Dermatol. 2018;17(3):511-7. http://doi.org/10.1111/jocd.12387
Rosenfield RL, Ehrmann DA. The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The Hypothesis of PCOS as Functional Ovarian Hyperandrogenism Revisited. Endocr Rev. 2016;37(5):467- 520. http://doi.org/10.1210/er.2015-1104
Buzney E, Sheu J, Buzney C, Reynolds RV. Poly cystic ovary syndrome: A review for dermatologists: Part II. Treatment. J Am Acad Dermatol. 2014;71(5):859.e1-859.e15. http://doi.org/10.1016/j.jaad.2014.05.009
Miyachi Y. Pathophysiology and diagnosis of Cushing’s syndrome. Biomed Pharmacother 2000;54(Suppl 1):113s-7s. http://doi.org/10.1016/s0753-3322(00)80026-8
Lizneva D, Gavrilova-Jordan L, Walker W, Azziz R. Androgen excess: Investigations and management Best Practice and Research: Clin Obstet Gynecol. 2016;37:98-118. http://doi.org/10.1016/j.bpobgyn.2016.05.003
Livadas S, Bothou C. Management of the Female With Non-classical Congenital Adrenal Hyperplasia (NCCAH): A Patient-Oriented Approach. Front Endocrinol. 2019;10:366. https://doi.org/10.3389/fendo.2019.00366
Dessinioti C, Katsambas AD. Congenital Adrenal Hyperplasia and Acne in the Male Patients. Dermatoendocrinol. 2009;1(2):87-91. http://doi.org/10.1007/978-3-540-69375-8_31
Trakakis E, Papadavid E, Dalamaga M, Koumaki D, Stavrianeas N, Rigopoulos D, et al. Prevalence of non classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency in Greek women with acne: a hospital-based cross-sectional study. J Eur Acad Dermatology Venereol. 2013;27(11):1448-51. http://doi.org/10.1111/j.1468-3083.2012.04613.x
Melnik B, John S, Plewig G. Acne: Risk Indicator for Increased Body Mass Index and Insulin Resistance. Acta Derm Venereol. 2013;93(6):644-9. http://doi.org/10.2340/00015555-1677
Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-973.e33. https://doi.org/10.1016/j.jaad.2015.12.037
Snast I, Dalal A, Twig G, Astman N, Kedem R, Levin D, et al. Acne and obesity: A nationwide study of 600,404 adolescents. J Am Acad Dermatol. 2019;81(3):723-9. https://doi.org/10.1016/j.jaad.2019.04.009
Lacroix A, Feelders RA, Stratakis CA, Nieman LK. Cushing’s syndrome. Lancet. 2015;386(9996):913- 27. https://doi.org/10.1016/S0140-6736(14)61375-1
Stewart P, Newell J. The adrenal cortex. En: Melmed S, Polonsky K, Larsen P, Kronenberg H. Williams Textbook of Endocrinology. 13.a edición. Elsevier; 2015.p. 489-555. Disponible en: https://bit.ly/2TALbt9
Gardner D, Shoback D. Greenspan’s Basic and Clinical Endocrinology. 9.a edición. McGraw-Hill; 2011.
Lolis MS, Bowe WP, Shalita AR. Acne and Systemic Disease. Med Clin North Am. 2009;93(6):1161-81. https://doi.org/10.1016/j.mcna.2009.08.008
Stratakis CA. Skin manifestations of Cushing’s syndrome. Rev Endocr Metab Disord. 2016;17(3):283-6. http://doi.org/10.1007/s11154-016-9399-3
Nguyen HL, Tollefson MM. Endocrine disorders and hormonal therapy for adolescent acne. Curr Opin Pediatr. 2017;29(4):455-65. http://doi.org/10.1097/MOP.0000000000000515
How to Cite
Downloads
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Revista de la Asociación Colombiana de Dermatología y Cirugía Dermatológica
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Article metrics | |
---|---|
Abstract views | |
Galley vies | |
PDF Views | |
HTML views | |
Other views |