A Guide to Hormonal Dermatology

Foreword 1
Foreword 2
Preface
Contents
Chapter 1: Overview of Endocrinology
	1.1 Disorder of the Hypothalamic-Pituitary Axis
		1.1.1 Acromegaly
			1.1.1.1 Dermatologic Manifestations
		1.1.2 Hypopituitarism
	1.2 Thyroid Related Disorders
		1.2.1 Hyperthyroidism
			1.2.1.1 Dermatological Manifestations
		1.2.2 Hypothyroidism
			1.2.2.1 Dermatological Manifestations
	1.3 Disorders of the Adrenal Gland
		1.3.1 Cushing Syndrome
			1.3.1.1 Dermatologic Manifestations
		1.3.2 Primary Adrenal Insufficiency
			1.3.2.1 Dermatologic Manifestations
				Hyperpigmentation
		1.3.3 Other Causes of Adrenal Insufficiency and Associated Skin Manifestations
			1.3.3.1 Skin Manifestations
		1.3.4 Pseudohypoaldosteronism
			1.3.4.1 Dermatological Manifestations
	1.4 Disorder of Parathyroid Hormone
		1.4.1 Dermatological Manifestations
	1.5 Disorder of the Endocrine Pancreas
		1.5.1 Diabetes Mellitus
			1.5.1.1 Dermatologic Manifestations
		1.5.2 Glucagonoma
			1.5.2.1 Dermatological Manifestations
	1.6 Disorder of Androgen Excess
		1.6.1 Polycystic Ovarian Syndrome
			1.6.1.1 Dermatologic Manifestations
	1.7 Hereditary Endocrine Syndromes
		1.7.1 Multiple Endocrine Neoplasia (MEN) Syndromes
			1.7.1.1 MEN1
			1.7.1.2 MEN 2
	1.8 Neurofibromatosis 1
		1.8.1 Skin Manifestations
	1.9 Von Hippel Lindau
		1.9.1 Skin Manifestations
	1.10 Conclusion
	References
Chapter 2: Obesity and Skin
	2.1 Introduction
	2.2 Effect of Obesity on Skin Pathophysiology
	2.3 Common Skin Changes Associated with Obesity
		2.3.1 Acanthosis Nigricans (AN)
		2.3.2 Keratosis Pilaris
		2.3.3 Achrocordons
		2.3.4 Striae Distensae (SD)
		2.3.5 Cellulite
		2.3.6 Plantar Hyperkeratosis
		2.3.7 Skin Infections
	2.4 Rare Skin Conditions Associated with Obesity
		2.4.1 Keratosis Follicularis Squamosa (Dohi; KFS)
		2.4.2 Adiposis Dolorosa/Dercum Disease (DD)
		2.4.3 Granular Parakeratosis
		2.4.4 Obesity Associated Lympedematous Mucinosis (OLAM)
	2.5 Inflammatory Skin Diseases Associated with Obesity
		2.5.1 Hidradenitis Suppurativa (HS)
		2.5.2 Psoriasis
		2.5.3 Rosacea
		2.5.4 Hair and Scalp
		2.5.5 Acne
		2.5.6 Skin Malignancy
	2.6 Conclusion
	References
Chapter 3: Vitamin D and Skin
	3.1 Introduction
	3.2 Vitamin D and Its Synthesis
	3.3 Functions of Vitamin D
	3.4 Vitamin D Deficiency
	3.5 Skin and Vitamin D
	3.6 Mechanism of Action of Vitamin D
	3.7 Atopic Dermatitis
	3.8 Psoriasis
	3.9 Vitiligo
	3.10 Skin Cancers
	3.11 Skin Pigmentation
	3.12 Anti-aging
	3.13 Other Skin Conditions
	3.14 Vitamin D Dosing, Toxicity and Management
	3.15 Conclusion
	References
Chapter 4: Thyroid Disorders and the Skin
	4.1 Introduction
	4.2 Thyroid Gland
		4.2.1 Anatomy
		4.2.2 Embryology
		4.2.3 Hormones
	4.3 Thyroid Diseases
		4.3.1 Laboratory Diagnosis
		4.3.2 Types and Epidemiology
		4.3.3 Hyperthyroidism
		4.3.4 Hypothyroidism
	4.4 Thyroid Cancer
	4.5 Alopecia Areata
	4.6 Chronic Idiopathic Urticaria
	4.7 Other Thyroid Dermopathies
	4.8 Dermatitis Herpetiformis
	4.9 Vitiligo
	4.10 Psoriasis
	4.11 Miscellaneous Diseases
	4.12 Conclusion
	References
Chapter 5: Cutaneous Manifestations of Diabetes
	5.1 Introduction
	5.2 Pathogenesis
	5.3 Cutaneous Manifestations Associated with Complications of Diabetes (Vascular and Neurological Damage)
		5.3.1 Diabetic Dermopathy
		5.3.2 Rubeosis Faciei
		5.3.3 Palmar Erythema
		5.3.4 Periungual Telangiectasias
		5.3.5 Diabetic Foot Syndrome
		5.3.6 Pigmented Purpuric Dermatoses
	5.4 Cutaneous Infections in Diabetes Mellitus
		5.4.1 Bacterial Infections
		5.4.2 Fungal Infections
	5.5 Skin Diseases Associated with Insulin Resistance, Obesity and Metabolic Syndrome (Table 5.5)
		5.5.1 Acanthosis Nigricans
		5.5.2 Eruptive Xanthomas (EX)
		5.5.3 Acrochordons
	5.6 Skin Manifestations Associated with Diabetes
		5.6.1 Granulomatous Disorders
		5.6.2 Stiff Skin and Joints
		5.6.3 Bullosis Diabeticorum
		5.6.4 Acquired Perforating Dermatosis
		5.6.5 Other Miscellaneous Disorders
	5.7 Cutaneous Changes Associated with Diabetes Medications (Table 5.6)
		5.7.1 Insulin
		5.7.2 Oral Medications
	References
Chapter 6: Pathophysiology of PCOS
	6.1 Introduction
	6.2 Definition of PCOS
	6.3 Phenotypes
	6.4 Pathophysiology of PCOS
	6.5 Factors Drive to PCOS (Fig. 6.2)
	6.6 Conclusion
	References
Chapter 7: PCOS Investigations and Clinical Implications
	7.1 Definition of PCOS
	7.2 Diagnostic Criteria Changing with Time
	7.3 Diagnosis of PCOS: AACE/ACE2015
	7.4 What About Other Tests
	7.5 Anti Mullerian Hormone (AMH)
	7.6 Serum 3ά-Diol G: As a Marker for Idiopathic Hirsutism (IH), PCOS with Hirsutism
		7.6.1 Alpha 3 Diol in Adult Acne
		7.6.2 Other Features of PCOS: Not Included in the Diagnostic Criteria
		7.6.3 Abnormal Gonadotrophin Secretion Measurements
		7.6.4 Summary and Key Points in Diagnosis of PCOS
	References
Chapter 8: PCOD-Management of ACNE
	8.1 Introduction
	8.2 Management
		8.2.1 Non-hormonal Therapy
		8.2.2 Oral Isotretinoin
		8.2.3 Oral Antibiotics
			8.2.3.1 Hormonal Therapy
		8.2.4 Combined Oral Contraceptives
		8.2.5 Spironolactone
		8.2.6 Androgen Receptor Blockers
			8.2.6.1 Cyproterone Acetate
			8.2.6.2 Flutamide
			8.2.6.3 Insulin-Sensitizing Agents
			8.2.6.4 Psychological Support
	References
Chapter 9: Management of Pigmentation in Polycystic Ovary Syndrome
	9.1 Introduction
	9.2 Acanthosis Nigricans
		9.2.1 Treatment
			9.2.1.1 General Counselling
			9.2.1.2 Topical Medications
			9.2.1.3 Systemic Medications
			9.2.1.4 In-Clinic Treatment
	9.3 Hyperprolactinemia
		9.3.1 Treatment
			9.3.1.1 Systemic Medications
			9.3.1.2 Pro Tip
	9.4 Seborrheic Dermatitis
		9.4.1 Treatment
			9.4.1.1 General Instruction
			9.4.1.2 Topicals
			9.4.1.3 Systemic Medications
			9.4.1.4 In-Clinic Treatment
	9.5 Post Acne PIH
		9.5.1 Treatment
			9.5.1.1 General Instructions
			9.5.1.2 Topical Therapy
			9.5.1.3 Oral Drugs
			9.5.1.4 Pro Tip
			9.5.1.5 In-Clinic Treatments
			9.5.1.6 Lasers and EBD
	9.6 DPN/Acrochordans
	9.7 Melasma
		9.7.1 General Instructions
			9.7.2 Topical Treatment
			9.7.3 In-Clinic Treatment
		9.7.4 Lasers and EBD
			9.8 Laser Induced Hyperpigmentation
		9.8.1 Treatment
			9.8.1.1 General Care
			9.8.1.2 Topical Therapy
			9.8.1.3 Oral Treatment
			9.8.1.4 In-Clinic Treatment
	9.9 Conclusion
	References
Chapter 10: Management of Hirsutism in PCOS
	10.1 Introduction
		10.1.1 Causes
		10.1.2 Evaluation
		10.1.3 Examination
	10.2 Treatments
		10.2.1 General Care
		10.2.2 Topical Treatment
		10.2.3 Oral Treatment
			10.2.3.1 Myoinostiol
			10.2.3.2 Oral Contraceptive Pills
	10.3 Anti Androgens
		10.3.1 Cyproterone Acetate [24]
		10.3.2 Spironolactone
		10.3.3 Flutamide/Bicalutamide [27]
		10.3.4 Finasteride/Dutasteride
			10.3.4.1 Glucocorticoids
			10.3.4.2 GnRH Analogues
			10.3.4.3 Insulin Sensitizers
			10.3.4.4 Antifungal Agents
		10.3.5 Alternative Therapies [31]
	10.4 In-Clinic Treatment
		10.4.1 Electrolysis [32]
		10.4.2 Lasers and Lights
		10.4.3 Mechanisms of Lasers
	10.5 Conclusion
	References
Chapter 11: PCOS-Management of Androgenetic Alopecia
	11.1 Introduction
		11.1.1 Pathogenesis
	11.2 Investigations
	11.3 Management
		11.3.1 5 Alpha-Reductase Inhibitors
			11.3.1.1 Finasteride
			11.3.1.2 Dutasteride
		11.3.2 Cyproterone Acetate
	11.4 Minoxidil
	11.5 Topical Therapy
		11.5.1 Minoxidil
	11.6 Lasers and Light Treatments
	11.7 Invasive Procedures
		11.7.1 Platelet Rich Plasma Therapy
	11.8 Microneedling
	11.9 Hair Transplantation
	11.10 Cosmetic Camouflage
	11.11 Conclusion
	References
Chapter 12: Counselling in Hair Transplant Patient
	12.1 Introduction
	12.2 Part 1: Basics of Hair Transplant
		12.2.1 Section 1: Types of Hair Transplant
			12.2.1.1 Beard, Eyebrow and Eyelash Transplant
		12.2.2 Section 2: Procedure of Hair Transplant
			12.2.2.1 Hairline Design Depends on
			12.2.2.2 Theory of Safe Donor Zone in FUE [9]
			12.2.2.3 Principles of Implantation
		12.2.3 Implantation Techniques: (Refer Table 12.3)
		12.2.4 Comprehensive Procedure Protocol
		12.2.5 Advantages of CPP
		12.2.6 Section 3: Benefits and Risks of Hair Transplant
			12.2.6.1 Benefits of Hair Transplant
			12.2.6.2 Possible Risks and Complications
	12.3 Part 2: Consultation
		12.3.1 Section 1: Purpose of Consultation
			12.3.1.1 Importance of Consultation for Hair Transplant by a Specialist
			12.3.1.2 Patient Selection
			12.3.1.3 How to Manage Unhappy or Difficult Patients
			12.3.1.4 What to Expect from a Consultation for Hair Transplant by a Specialist
		12.3.2 Section 2: Components of Consultation
			12.3.2.1 Hamilton-Norwood Classification
			12.3.2.2 During the Consultation
			12.3.2.3 During the Pre-Operative Stage
			12.3.2.4 During the Surgery (Refer Fig. 12.7)
			12.3.2.5 In the Post-Operative Stage
			12.3.2.6 Summary Points to Be Followed for Better Consultation
	References
Chapter 13: Importance of Nutrition & Diet in PCOS
	13.1 Introduction
		13.1.1 Physiological Basis
	13.2 Role of Gut Microbiome
		13.2.1 Oxidative Stress and Chronic Inflammation
	13.3 Dietary Patterns and PCOS
		13.3.1 Mediterranean Diet
		13.3.2 Ketogenic Diet
		13.3.3 Low Glycemic Diet (LGI)
		13.3.4 Pulse Based High Fiber Diet
	13.4 Conclusion
	References
Chapter 14: Urticaria and Hormones
	14.1 Introduction
	14.2 Thyroid and Urticaria
		14.2.1 Pathogenesis
		14.2.2 Predisposing Factors
		14.2.3 Urticaria and Thyroid Abnormality Associations
		14.2.4 Clinical Features
		14.2.5 Diagnosis
		14.2.6 Treatment
	14.3 Estrogen and Urticaria
		14.3.1 Pathogenesis
		14.3.2 Clinical Features
		14.3.3 Diagnosis
		14.3.4 Treatment
	14.4 Progesterone and Urticaria
		14.4.1 Pathogenesis
		14.4.2 Clinical Features
		14.4.3 Diagnosis
		14.4.4 Clinical Implications
		14.4.5 Associations
		14.4.6 Treatment
	14.5 Metabolic Syndrome and Urticaria
		14.5.1 Pathogenesis
		14.5.2 Predisposing Factors
		14.5.3 Clinical Features
		14.5.4 Clinical Implications
		14.5.5 Associations
		14.5.6 Diagnosis
		14.5.7 Treatment
	14.6 Conclusion
	References