The SAHA Syndrome

Orfanos, Constantin E.; Adler, YaeI D.; Zouboulis, Christos C.

doi:10.1159/000053267

Cited by 81 publications

(61 citation statements)

References 41 publications

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“…However, only a few patients with androgenic disorders exhibit hyperandrogenemia, an observation which indicates the predominance of peripheral tissue events for the occurrence of clinical signs. 32 Enhanced sebaceous gland activity is attributed to the potent androgen 5α-DHT 5 as sebaceous gland cells possess all necessary enzymes for conversion of testosterone to 5α-DHT. 33 The isozyme 5α-reductase type I, which catalyses the conversion from testosterone to 5α-DHT in peripheral tissues by a NADPH-dependent reaction is expressed predominantly in skin.…”

Section: Effects Of Hormones On Sebaceous Gland Cellsmentioning

confidence: 99%

An update on the role of the sebaceous gland in the pathogenesis of acne

Makrantonaki

Gancevičienė²,

Zouboulis³

2011

Dermato-Endocrinology

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230

168

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Section: Effects Of Hormones On Sebaceous Gland Cellsmentioning

confidence: 99%

An update on the role of the sebaceous gland in the pathogenesis of acne

Makrantonaki

Gancevičienė²,

Zouboulis³

2011

Dermato-Endocrinology

Self Cite

230

168

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“…In the widest sense, the human skin and its cells are the targets as well as the producers of hormones. For example, the circulating androgens dehydroepiandrosterone (DHEA) and androstenedione are converted in the skin to testosterone and further to 5a-dihydrotestosterone (5a-DHT) 3,8 .…”

Section: Introductionmentioning

confidence: 99%

The human skin as a hormone target and an endocrine gland

Zouboulis¹

2004

159

116

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Hormones influence the development and function of human skin which also produces and releases hormones. Recently attention has been focused on identifying and understanding the complex endocrine properties of human skin, such as expression and function of specific hormone receptors, synthesis of hormones from major classes of compounds used by the body for general purposes, organized metabolism, activation, inactivation and elimination of the hormones in specialized cells of the tissue, exertion of biological activity and release of tissue hormones in the circulation. Specifically, hormones exert their biological effects on the skin through interaction with high-affinity receptors, such as several receptors for peptide hormones and neurotransmitters, steroid and thyroid hormones. Hormones exhibit a wide range of biological activities on the skin with distinct effects caused by growth hormone/insulin-like growth factor-I, neuropeptides, sex steroids, glucocorticoids, retinoids, vitamin D, peroxisome proliferator-activated receptor ligands, eicosanoids, melatonin and serotonin. Human skin produces, activates or inactivates metabolically numerous hormones which are probably important for skin functions but also for functions of the entire human organism, such as sex hormones, especially in aged individuals, insulin-like growth factor and -binding proteins, neuropeptides, prolactin, catecholamines, retinoids, steroids, vitamin D and eicosanoids. These functions are undertaken in most cases by different skin cell populations in a coordinated way, indicating the endocrine autonomy of the skin. Characteristic examples are the metabolic pathways of the corticotropin-releasing hormone/propiomelanocortin axis, steroidogenesis, vitamin D and retinoids. The human skin is, thus, the largest, peripheral endocrine organ.

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“…Insbesondere bei der Akne im Pubertätsalter ist eine längerfristige prophylaktische Therapie und eine Nachsorge über mehrere Jahre auch nach der klinischen Abheilung notwendig. Bei infantiler und juveniler Akne, bei Androgenisierungszeichen in weiblichen Patienten mit Acne tarda [20,21] [12]. Neben der klassischen Therapie steht eine…”

Section: Allgemeine Richtlinien Zur Aknetherapieunclassified

Moderne Aknetherapie

Zouboulis¹

2003

Akt Dermatol

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ZusammenfassungAkne ist die häufigste dermatologische Erkrankung: Rund 70 ± 87 % aller Jugendlichen weisen Akneläsionen auf, 10 ± 30 % davon benötigen eine medikamentöse Therapie. Bei der Mehrzahl der Patienten erfolgt nach der Pubertät eine spontane Rück-bildung, davon 2 ± 7 % mit erheblicher Narbenbildung. In 10 % der Fälle persistiert die Erkrankung über das 25. Lebensjahr hinaus. Die Auswahl eines Behandlungsschemas ist von der exakten Klassifikation der Akne und der Einordnung des Schweregrades abhängig. Insbesondere stellt die Entwicklung von Narben das Hauptkriterium für die Wahl einer systemischen Therapie dar. Retinoide für die nicht-entzündlichen und Benzoylperoxid für die entzündlichen Akneläsionen sind die Medikamente der ersten Wahl für eine topische Aknetherapie, wobei die Azelainsäure für milde Akneformen und zur Erhaltung eines Therapierfolges geeignet ist. Die Anwendung topischer Antibiotika nimmt ± insbesondere aufgrund der Entwicklung resistenter Bakterienstäm-me durch ihren Einsatz ± kontinuierlich ab. Bei der topischen Therapie spielt die Wahl der Grundlage eine übergeordnete Rolle. Antibiotika, Antiandrogene ± in der Form von hormonellen Kontrazeptiva ± und Isotretinoin sind die aktuellen Pfeiler der systemischen Aknetherapie. Kortikosteroide werden bei der Therapie der Acne fulminans, niedrig dosiert auch bei der Behandlung von Patienten mit adrenalem Hypergonadismus eingesetzt. Aktuelle neue Entwicklungen könnten interessante Perspektiven in der zukünftigen Therapie der Akne anbieten. AbstractAcne is the most common skin disease with a prevalence of 70 ± 87% in adolescents. Ten to 30% of the individuals involved require medical treatment. The majority of patients experiences a spontaneous resolution of the disease after puberty, however in 2-7% the lesions heal with significant scarring. Ten percent of the patients exhibit persistence of their lesions over the age of 25 years. The selection of a therapeutic regimen is dependent on the classification type of acne and its severity grade. In particular, the major criterium leading to the decision for a systemic treatment is the development of scars. Retinoids and benzoyl peroxide are first choice topical drugs for the non inflammatory and the inflammatory lesions, respectively. Azelaic acid is only recommended for mild acne lesions and for the preservation of a successful therapeutic result obtained by another regimen. The application of topical antibiotics is continuously reduced, especially due to the development of resistant bacterial strains. The type of the vehicle is essential for the effectiveness of the topical treatment. Antibiotics, antiandrogens (in hormonal contraceptive preparations), and isotretinoin are the milestones of systemic acne treatment. Corticosteroids are administered in acne fulminans, also as low dose regimen in acne patients with adrenal hypergonadism. Currently, new developments offer interesting perspectives for the future acne treatment.

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The SAHA Syndrome

Cited by 81 publications

References 41 publications

An update on the role of the sebaceous gland in the pathogenesis of acne

An update on the role of the sebaceous gland in the pathogenesis of acne

The human skin as a hormone target and an endocrine gland

Moderne Aknetherapie

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