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An İ, Kahraman FC, Bilgiç A, Aktürk AŞ, Albayrak H, Kartal D, Çınar SL, Solak SS, Uslu M, Şanlı HE, Yıldızhan İK, Şahin MT, Zindanci İ, Savaş S, Ayhan E, Cinel M, Ataş ENS, Aydemir M, Selek A, Elbüken G, Zuhur SS, Karaca Z, Bülbül BY, Ünübol M, Demir Ö, Hekimsoy Z, Tuna M, Asilsoy M, Çetin S. Cutaneous findings in patients with acromegaly and its relationship with concomitant endocrinopathies. Clin Endocrinol (Oxf) 2024; 101:255-262. [PMID: 38712950 DOI: 10.1111/cen.15071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/22/2024] [Accepted: 04/27/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVES Skin changes in acromegaly are often the first sign of the disease. The aim of this study was to describe the cutaneous findings in patients with acromegaly. In addition, a secondary aim was to investigate the possible association of these findings with remission status and concomitant endocrinopathies. DESIGN, PATIENTS, AND MEASUREMENTS In this prospective multicenter study, 278 patients over the age of 18 years with acromegaly who were followed up in 14 different tertiary healthcare institutions were included. These patients, who were followed up by the Endocrinology Department, were then referred to a dermatologist for dermatological examination. The frequency of skin lesions was investigated by detailed dermatologic examination. Dermatological diagnosis is reached by clinical, dermatological and/or dermoscopic examination, and rarely skin punch biopsy examinations in suspicious cases. The possible association of the skin findings between remitted and nonremitted patients and with concomitant endocrinopathies were evaluated. RESULTS The most common skin findings in patients with acromegaly in our study were skin tags (52.5%), cherry angiomas (47.4%), seborrhoea (37%), varicose veins (33%), acneiform lesions (28.8%), hyperhidrosis (26.9%) and hypertrichosis (18.3%). Hypertrichosis was significantly more prevalent in patients nonremitted (p: .001), while xerosis cutis was significantly more prevalent in patients remitted (p: .001). The frequency of diabetes mellitus and hypothyroidism was significantly higher in patients with varicose veins and seborrhoeic keratosis than those without. Additionally, the coexistence of hypothyroidism, hyperthyroidism and galactorrhea was significantly higher in patients with Cherry angioma than in those without Cherry angioma (p-values: .024, .034 and .027, respectively). The frequency of hypogonadism in those with xerosis cutis was significantly higher than in those without (p: .035). CONCLUSIONS Cutaneous androgenization findings such as skin tag, seborrhoea, acne and acanthosis nigricans are common in patients with acromegaly. Clinicians should be aware that skin findings associated with insulin resistance may develop in these patients. It can be said that the remission state in acromegaly has no curative effect on cutaneous findings. Only patients in remission were less likely to have hypertrichosis. This may allow earlier review of the follow-up and treatment of acromegaly patients presenting with complaints of hypertrichosis. Additionally, it can be said that patients with skin findings such as cherry angioma may be predisposed to a second endocrinopathy, especially hypothyroidism. Including dermatology in a multidisciplinary perspective in acromegaly patient management would be beneficial to detect cutaneous findings earlier.
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Affiliation(s)
- İsa An
- Department of Dermatology, Şanlıurfa Training and Research Hospital, Sanlıurfa, Turkey
| | - Filiz Cebeci Kahraman
- Department of Dermatology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey
| | - Aslı Bilgiç
- Department of Dermatology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Aysun Şikar Aktürk
- Department of Dermatology, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Hülya Albayrak
- Department of Dermatology, Namık Kemal University Medical Faculty, Turkey
| | - Demet Kartal
- Department of Dermatology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Salih Levent Çınar
- Department of Dermatology, Erciyes University Medical Faculty, Kayseri, Turkey
| | | | - Meltem Uslu
- Department of Dermatology, Adnan Menderes University Medical Faculty, Turkey
| | - Hatice Erdi Şanlı
- Department of Dermatology, Ankara University Medical Faculty, Ankara, Turkey
| | | | - Mustafa Turhan Şahin
- Department of Dermatology, Celal Bayar University Medical Faculty, Manisa, Turkey
| | - İlkin Zindanci
- Department of Dermatology, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Sevil Savaş
- Department of Dermatology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Erhan Ayhan
- Department of Dermatology, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Murat Cinel
- Department of Endocrinology and Metabolism, Mehmet Akif Inan Education and Research Hospital, Şanlıurfa, Turkey
| | - Elif Nazlı Serin Ataş
- Department of Endocrinology and Metabolism, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Mustafa Aydemir
- Department of Endocrinology and Metabolism, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Alev Selek
- Department of Endocrinology and Metabolism, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Gülşah Elbüken
- Department of Endocrinology and Metabolism, Namık Kemal University Medical Faculty, Turkey
| | - Sayid Shafi Zuhur
- Department of Endocrinology and Metabolism, Namık Kemal University Medical Faculty, Turkey
| | - Züleyha Karaca
- Department of Endocrinology and Metabolism, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Buket Yılmaz Bülbül
- Department of Endocrinology and Metabolism, Trakya University Medical Faculty, Edirne, Turkey
| | - Mustafa Ünübol
- Department of Endocrinology and Metabolism, Adnan Menderes University Medical Faculty, Turkey
| | - Özgür Demir
- Department of Endocrinology and Metabolism, Ankara University Medical Faculty, Ankara, Turkey
| | - Zeliha Hekimsoy
- Department of Endocrinology and Metabolism, Celal Bayar University Medical Faculty, Manisa, Turkey
| | - Mazhar Tuna
- Department of Endocrinology and Metabolism, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Miray Asilsoy
- Department of Endocrinology and Metabolism, Sultan 2. Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Sedat Çetin
- Department of Endocrinology and Metabolism, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
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Resende M, Bolfi F, Nunes VDS, Miot HA. Prevalence of dermatologic disorders in 15 patients with acromegaly. An Bras Dermatol 2012; 87:166-8. [PMID: 22481676 DOI: 10.1590/s0365-05962012000100031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Accepted: 12/27/2010] [Indexed: 11/22/2022] Open
Abstract
Acromegaly is a chronic, insidious and rare disease, caused by hyper secretion of the growth hormone, which metabolic and trophic effects commonly result in cutaneous manifestations, sometimes preceding other clinical symptoms. The authors have assessed 15 patients with acromegaly and found dermatologic lesions in all of them, mainly skin thickening, acrochordons, epidermoid cysts, pseudoacanthosis nigricans, seborrheic keratosis, melanocytic naevi and lentiginous spots.
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Affiliation(s)
- Mariângela Resende
- Dermatology and Radiology Department, Universidade Estadual Paulista "Julio de Mesquita Filho", Botucatu, SP, Brasil
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