Cutaneous findings in patients with acromegaly

Dermatology Online Journal

Journal of Physical Medicine Rehabilitation Studies & Reports, 2021

Acromegaly is a disease or disorder that is caused by the hyper secretion of growth hormone from the anterior pituitary, that results in the excessive growth of tissues of body and dysfunctioning of other metabolic processes. Acromegaly is usually caused by the non-cancerous (benign) tumour and middle-aged people are mostly affected by it. Patients with acromegaly have pain in the joints, physical deformities, deepening of voice, bulging chest, protruding lower jaw, large feet and hands, oily skin, vision disorder or erectile dysfunction (impotence). Acromegaly occurs after the fusion of growth plates while gigantism occurs before the fusion of growth plates. This article reviews the pathophysiology and management of acromegaly as well as it highlights the etiology and epidemiology of acromegaly

European Journal of Endocrinology, 2001

Objective: To evaluate the histomorphology of skin and its appendages, especially eccrine sweat glands, in patients with GH disorders, because reduced sweating ability in patients with growth hormone de®ciency (GHD) is associated with increased risk of hyperthermia under stressed conditions. Design and methods: A skin biopsy was obtained from 17 patients with GHD treated with GH, ®ve patients with untreated GHD, 10 patients with active acromegaly and 13 healthy controls. Results: The sweat secretion rate (SSR) was signi®cantly decreased in both the untreated (median 41 mg/30 min, range 9±79 mg/30 min) and the GH-treated (median 98 mg/30 min, range 28± 147 mg/30 min) patients with GHD compared with that in controls (median 119 mg/30 min, range 90±189 mg/30 min; P 0X001 and 0.01 respectively). Epidermal thickness was signi®cantly decreased in both untreated (median 39 mm, range 28±55 mm) and GH-treated patients with GHD (median 53 mm, range 37±100 mm), compared with that in controls (median 66 mm, range 40± 111 mm; P , 0X02X A statistically non-signi®cant tendency towards thinner epidermis (median 59 mm, range 33±83 mm) was recorded in acromegalic patients P 0X08 compared with controls. There was no signi®cant difference in the area of the sebaceous glands in the biopsies between the three groups and the controls. The area of eccrine sweat gland glomeruli was signi®cantly decreased in the untreated patients with GHD (median 16407 mm 2 , range 12758±43976 mm 2 ) compared with that in controls (median 29446 mm 2 , range 13511±128661 mm 2 ; P 0X03Y but there was no signi®cant difference between the GH-treated patients with GHD and controls. Conclusions: We conclude that GH, either directly or via IGF-I, may have both a structural and a functional effect on human skin and its appendages, and that patients with GHD have histomorphological changes in skin compared with controls. Importantly, these changes are not fully reversed despite long-term and adequate GH treatment in patients with childhood onset GHD.

Journal of Clinical Medicine, 2019

Background: Acromegaly results from a persistent excess in growth hormone with clinical features that may be subtle or severe. The most common cause of acromegaly is a pituitary tumor that causes excessive production of growth hormone (GH), and rare cases are due to an excess of the GH-releasing hormone (GHRH) or the ectopic production of GH. Objective: Discuss the different diseases that present with manifestations of GH excess and clinical acromegaly, emphasizing the distinct clinical and radiological characteristics of the different pathological entities. Methods: We performed a narrative review of the published clinicopathological information about acromegaly. An English-language search for relevant studies was conducted on PubMed from inception to 1 August 2019. The reference lists of relevant studies were also reviewed. Results: Pituitary tumors that cause GH excess have several variants, including pure somatotroph tumors that can be densely or sparsely granulated, or plurihor...

The Western journal of medicine, 1985

International journal of endocrinology, 2012

Acromegaly and gigantism are due to excess GH production, usually as a result of a pituitary adenoma. The incidence of acromegaly is 5 cases per million per year and the prevalence is 60 cases per million. Clinical manifestations in each patient depend on the levels of GH and IGF-I, age, tumor size, and the delay in diagnosis. Manifestations of acromegaly are varied and include acral and soft tissue overgrowth, joint pain, diabetes mellitus, hypertension, and heart and respiratory failure. Acromegaly is a disabling disease that is associated with increased morbidity and reduced life expectancy. The diagnosis is based primarily on clinical features and confirmed by measuring GH levels after oral glucose loading and the estimation of IGF-I. It has been suggested that the rate of mortality in patients with acromegaly is correlated with the degree of control of GH. Adequately treated, the relative mortality risk can be markedly reduced towards normal.

2014

Acromegaly is a disorder characterized by Growth Hor­mone (GH) hypersecretion, multisystem-associated mor­ bidities, and increased mortality. Growth hormone is secreted by anterior part of the pituitary gland and it influences the growth of bone and soft tissue. Hypersecretion or hyposecretion of this hormone has a marked influence on the normal development of an individual. It also has marked influence on the development of oro-facial features, including the align­ ment of teeth, and mandibular prognathism, which compromises the aesthetics of an individual. Hence dental professionals have a role in diagnosing this disorder. We present here, a case report of Acromegaly.

Endokrynologia Polska

Acromegaly is a rare disease caused by excessive production of growth hormone (GH), typically by a pituitary tumour. The diagnosis is usually delayed, and patients frequently develop various complications that cause premature mortality. In patients with hypertension, heart failure, diabetes, and arthropathies that are not age-specific, attention should be paid to signs of acromegaly. Insulin-like growth factor 1 (IGF-1) assay should be used as a screening test whenever acromegaly is suspected. Further diagnostic investigations and treatment should be carried out at specialist centres. First-line treatment involves selective excision of pituitary adenoma using transsphenoidal access. Patients with chances of cure with surgical removal of the pituitary tumour should be referred to centres that have experience in this type of procedure, following pharmacological preparation. Other patients, as well as patients after failed neurosurgical treatment, should first receive chronic treatment with first-generation somatostatin analogues. For second-line treatment, pasireotide, pegvisomant, cabergoline, or combinations thereof should be considered. In every case, acromegaly sequelae require lifelong monitoring and active treatment. Current recommendations, being an updated version of the recommendations published in Endokrynologia Polska in 2014, which take into account the Polish situation, should prove useful in the management of patients with acromegaly.

The Journal of Clinical Endocrinology & Metabolism, 2004

Arquivos Brasileiros De Endocrinologia E Metabologia, 2009

OBJECTIVES: The use of drug therapy based on cabergoline, octreotide and long-acting release (LAR) octreotide has presented varying results in the treatment of GH excessive production in patients with McCune-Albright Syndrome. METHODS: We report the case of a 29 year-old female patient presenting McCune-Albright Syndrome and complaint of excessive bone growth. RESULTS: The patient presented a pituitary adenoma involving the right internal carotid artery and excessive secretion of growth hormone (no GH suppression was observed after the oral glucose tolerance test). Due to the presence of diffuse thickness in skull base bones, surgical approach was not considered effective and the patient was submitted to drug therapy with octreotide LAR and cabergoline. At the one year follow-up, GH and IGF-1 levels were normal and no adverse effects were present. CONCLUSION: The use of drug therapy based on the association of cabergoline and octreotide is safe and able to achieve complete hormonal control in the treatment of acromegaly for McCune-Albright patients.