Endocrinologist told about the manifestation of internal problems on the skin

Diseases of the endocrine system are accompanied by skin manifestations, the range of which is diverse and can vary from common signs such as acne, hirsutism (increased hair loss), hyper- or hypopigmentation, to extremely rare forms of dermatosis. Karina Delova, an endocrinologist at Paracelsus Medical Center, told Izvestia on February 13.

"These symptoms can significantly affect the quality of life of patients. The most common skin lesions are found in endocrinopathies, namely in disorders of the thyroid gland, hypothalamic-pituitary axis, pancreas, adrenal glands, androgenic axis, as well as in hereditary endocrine syndromes," - specified the doctor.

According to her, skin manifestations can be the first and isolated sign of the development of endocrine pathology, so it is dermatologists and therapists should know the skin symptoms of endocrine disorders for referral to endocrinologists.

"The skin is a visually accessible organ through which physicians can diagnose and monitor various somatic diseases, including endocrine diseases. The mechanism of endocrinologic dermatoses is quite complex, their spectrum of manifestations is quite wide," Delova added.

She specified that some skin rashes may appear at an early stage of hormonal disorders.

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Skin problems may indicate hyperthyroidism. It develops due to a pathological increase in the synthesis and secretion of thyroid hormones of the thyroid gland. It is manifested by hyperhidrosis (increased sweating), which is observed on the palms and soles. Hyperthyroidism is also characterized by erythema (redness) of the palms, swelling and meniscus-like drooping of the eyelids. Hair thins, becomes greasy, and 20% of patients may have diffuse alopecia, the doctor explained.

Another condition is hypothyroidism, which is associated with decreased thyroid function.

"Skin symptoms of hypothyroidism include dry skin, jaundice, myxedematous edema of the face and/or extremities and periorbital edema, hypothermia, hair breakage and hair loss on the lateral parts of the eyebrows, head (up to nested baldness and alopecia), axillae and pubic area," Delova said.

She also noted glucagonoma. This is a malignant tumor of the alpha cells of the pancreas, secreting glucagon and leading to the development of hyperglycemia, diabetes mellitus, characteristic rash.

"Cutaneous manifestations. The typical sign of glucagonoma is a long-lasting rash on the skin of the extremities, often associated with changes in the tongue (smooth, shiny, bright red in color) and cheilitis (an inflammatory disease affecting the skin and mucosa of the lips. - Ed.). This rash is a flaky brown-red erythema," - specified the endocrinologist.

At the same time, skin manifestations in patients with diabetes can be quite different, the expert added. They are associated with metabolic changes. Black acanthosis (a disease in which dark spots appear in the folds of the skin), hyperpigmentation of the skin of the elbows, knees and back of the hands, recurrent skin fungal or bacterial infections, generalized and localized skin itching can be observed.

Icenko-Cushing syndrome (CIC) is characterized by a number of clinical manifestations resulting from excessive glucocorticoid secretion.

"Cutaneous manifestations of SIC are abnormal distribution of fat on the body, face ("moon-shaped face") and back ("buffalo hump"), pronounced skin atrophy with the development of purple striae (stretch marks. - Ed.), slow healing of wounds, acne," the doctor pointed out.

She also singled out hyperandrogenism, which is defined as an excess of androgens in women. The most common cause of its occurrence is polycystic ovary syndrome.

"Cutaneous manifestations in hyperandrogenism include hirsutism, acne vulgaris and seborrhea, and androgenic alopecia. Hirsutism is defined as excessive growth of terminal hair in a male pattern, including the beard area (face and neck), back, chest, and lower abdomen. The skin becomes thickened and rough. Other frequent manifestations of this disorder include black acanthosis caused by insulin resistance and hyperinsulinism," Delova explained.

Earlier, on February 1, Natalya Mikhailova, a dermatovenerologist and scientific director of MARTINEX, told Izvestia that some pathological conditions of the gastrointestinal tract are often associated with dermatological manifestations. Gastritis and peptic ulcer disease, for example, can be accompanied by skin reactions such as rosacea, redness and vascular changes.