A study of androgen and estrogen receptors alpha, beta in skin tags

Omar El Safoury, Lila Rashid, Magdy Ibrahim, Omar El Safoury, Lila Rashid, Magdy Ibrahim

Abstract

Background: In women, the age of 50 is suggested to be the turning point of life at which the development of skin tags comes to a stop. A major event that occurs around this period of life is menopause/andropause. After menopause, estrogen receptors amounts decrease significantly. As skin is considered as the largest nonreproductive target on which estrogens and androgens act, we assume a possible relationship between the pathogenesis of skin tags and sex steroid balance. Another phenomenon is the association of skin tags in obese patients, which may also be explained by the interplay of sex steroids and their receptors in skin tags.

Aims: Here we see that in obese patients, hyperandrogenism occurs as a result of hyperinsulinemia as well as peripheral conversion of estrogens into androgens in the excessive adipose tissue. To examine the possible role of androgen and estrogen receptors in etiopathogenesis of skin tags.

Materials and methods: To examine these hypotheses, we measured the level of androgen and estrogen receptors (both alpha and beta) in skin tags compared to control. We also correlated the level of receptors to body mass index, and compared those levels in patients with acanthosis nigricans compared to normal.

Results: The level of estrogen receptors (both alpha and beta) was significantly higher in skin tags than in controls with a P value of 0.004 and 0.001, respectively. The same upsurge was found for androgen receptors in skin tags relative to control with a P value of 0.001. No statistically significant difference in receptor level was found either among patients with acanthosis nigricans and those without, or in correlation to body mass index (our participants were overweight non diabetic).

Conclusion: These results suggest the possible role of androgen and estrogen receptors in etiogenesis of skin tags, and propose that the neck is an androgen dependent area just similar to the axillae and the groins, though hairless.

Keywords: Androgen receptors; acanthosis nigricans; body mass index; estrogen α receptors; estrogen β receptors; mast cell; obesity; sex hormone receptors; skin tags.

Conflict of interest statement

Conflict of Interest: Nil.

Figures

Figure 1
Figure 1
Mean receptor level in the skin tags versus normal skin
Figure 2
Figure 2
Mean receptor level in cases with Acanthosis nigricans (AN) versus those without (No AN)
Figure 3
Figure 3
Suggested scenario of skin tags formation

References

    1. Hall G, Phillips TJ. Estrogen and skin. The effects of estrogen, menopause, and hormone replacement therapy on the skin. J Am Acad Dermatol. 2005;53:555–68.
    1. Banik R, Lubach D. Skin Tags. Localization and Frequencies According to Sex and Age. Dermatologica. 1987;174:180–3.
    1. Meza-Muñoz DE, Fajardo ME, Pérez-Luque EL, Malacara JM. Factors associated with estrogen receptors-α (ER-α) and -β (ER-β) and progesterone receptor abundance in obese and non obese pre- and post-menopausal women. Steroids. 2006;71:498–503.
    1. Brickner SM. Fibroma molluscum gravidarum. Am J Derm genito-urin Dis. 1912;16:240.
    1. Cohen PG. The hypogonadal-obesity cycle: Role of aromatase in modulating the testosterone-estradiol shunt-A major factor in genesis of morbid obesity. Med Hypotheses. 1999;52:49–51.
    1. Cordain L, Eades MR, Eades MD. Hyperinsulinemic diseases of civilization more than just syndrome X. Comp Biochem Physiol A Mol Integr Physiol. 2003;136:95–112.
    1. Eknoyan G. Adolphe Quetelet (1796-1874) - The average man and indices of obesity. Nephrol Dial Transplant. 2008;23:47–51.
    1. Chomczynski P, Sacchi N. Single step method for RNA isolation by the acid guanidinum thiocyanate-phenol-chloroform method. Anal Biochem. 1987;162:156–60.
    1. Puneet Bhargara. Deepak Mathur. Acrochordon, diabetes and associations. Indian J of Dermal and Veneriol. 1996;62(4):226–8.
    1. Diamanti-Kandarakis E, Bergiele A. The influence of obesity on hyperandrogenism and infertility in the female. Obes Rev. 2001;2:231–7.
    1. Bélanger C, Hould FS, Lebel S, Biron S, Brochu G, Tchernof A. Omental and subcutaneous adipose tissue steroid levels in obese men. Steroids. 2006;71:674–82.
    1. Zumoff B. Hormonal abnormalities in obesity. Acta Med Scand. 1988;723:153–60.
    1. Verdier-Sevrain S, Yaar M, Cantatore J, Traish A, Gilchrest BA. Estradiol induces proliferation of keratinocytes via receptor-mediated mechanisms. FASEB J. 2004;18:1252–4.
    1. Tomaszewski J, Adamiak A, Skorupski P, Rzeski W, Rechberger T. Effect of 17 β estadiol and phytoestrogen daidzein on the proliferation of pubocervical fascia and skin fibroblasts derived from women suffering from stress urinary incontinence. Ginekol Pol. 2003;74:1410–4.
    1. Zaher H, El Safoury OS, El Komy MM, Mahmoud SB, El Hameed HA. Study of mast cell count in skin tags. Indian J Dermatol. 2007;52:184–7.
    1. Di Matteo L. Vitieello I.I and Minucci S. Effect of sex steroid hormones and antagonists on mast cell number in the testis of frog. Rana esculenta Zygot. 2000;8:225–34.
    1. Zaitsu M, Narita S, Lambert KC, Grady JJ, Estes DM, Curran EM, et al. Estradiol activates mast cells via a non-genomic estrogen receptor-α and calcium influx. Mol Immunol. 2007;44:1977–85.
    1. Vliagoftis H, Dimitriadou V, Boucher W, Rozniecki JJ, Correia I, Raam S, et al. Estradiol augments while tamoxifen inhibits rat mast cell secretion. Int Arch Allergy Immunol. 1992;98:398–409.
    1. Hamilton KS, Johnson S, Smoller BR. Role of androgen receptors in clinical course of Nevus Sebaceus of Jadassohn. Mod Pathol. 2001;14:539–49.
    1. Eil C, Cutler GB, Jr, Loriaux DL. Androgen receptor characteristics in skin fibroblasts from hirsute women. J Invest Dermatol. 1985;84:62–5.

Source: PubMed

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