Pituitary gland diseases

Excessive secretion of pituitary hormones, as well as their deficiency, may cause a constellation of clinical and pathological manifestations involving major organ systems of the body, including the skin. There are no specific cutaneous signs or symptoms that are pathognomonic for the main manifestations of pituitary gland diseases such as acromegaly, hyperprolactinemia, Cushing's disease, or hypopituitarism. In addition to tissue hyperplasia, which is the hallmark of the disease, patients with acromegaly present with skin thickening, excessive sebaceous, eccrine and apocrine secretion, skin tags, and cutis verticis gyrata. In the setting of hyperprolactinemia, galactorrhea in women and gynecomastia or impotence in men are associated with acne vulgaris, seborrhea, androgenetic alopecia, and hirsutism. Rubeosis faciei, epidermal atrophy, acne, purpura, hirsutism, and striae distensae are the main features of ACTH-dependent Cushing's disease in association with hyperpigmentation. Skin manifestations, although not pathognomonic, may be the first sign of underlying pituitary gland disease and can allow early detection and intervention, reducing the adverse medical implications. © 2010 Springer Science+Business Media, LLC.