Pituitary gland diseases, skin changesjeweiliges Krankheitsbild

Pathological changes of the pituitary gland are not rare; in the dermatological clientele pituitary diseases play only a minor role. The majority of the mostly randomly diagnosed changes (detectable masses) do not cause clinical symptoms.

Depending on the symptoms of the disorder, the following dermatologically relevant clinical pictures can be diganostized:

• Hypofunction of the pituitary partial functions (disorders of the gonadotropic and/or somatotropic partial functions).
• Gonadotropic insufficiency (see below gonadotropins):
• Decrease of libido and potency, secondary amenorrhea, infertility, loss of secondary hair. In testosterone deficiency: reduction in muscle mass and increase in fat mass, testicular atrophy, reduced beard growth. In children: lack of puberty (see also Kallmann syndrome; see also adrenogenital syndrome, congenital).
• Somatotropic insufficiency:
• Increase in fat mass and decrease in muscle mass and bone density. Decrease in performance and quality of life, increased risk of hyperlipidaemia and hypertension and consequently increased cardiovascular mortality. Decreased growth in children.
• Thyrotropic insufficiency (see hypothyroidism)
• Corticotropic insufficiency (see below Addison, whiter).
• Hyperfunction of pituitary partial functions:
• Prolactin-producing adenomas:
• amenorrhoea, possibly galactorrhoea (see also PCOS), effluvium, acne vulgaris, hirsutism.
• STH-producing adenomas:
• Acromegaly.
• ACTH-producing adenomas:
• See Cushing's syndrome below.

An endocrinological clarification of pituitary gland diseases is always necessary, but is usually complex due to the pulsatile release of anterior pituitary hormones, their pronounced daily rhythm and the influence of stress (both physical and psychological), nutritional status and age. In many cases the one-time determination of the serum or plasma concentration of a hormone is not useful. In general, only dynamic tests (stimulation or suppression) allow the assessment of the functional status. The tests should always be performed by an experienced endocrinologist.