Cammisa Ignazio, Zona Margherita, Guerriero Cristina, Cipolla Clelia, Rigante Donato
Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Children (Basel). 2024 Dec 6;11(12):1488. doi: 10.3390/children11121488.
Thyroid function plays a seminal role in the growth and development of children, and alterations in signaling pathways which interfere with the biosynthesis, transport, and metabolism of thyroid hormones might impact on the skin of such patients: this review explores the relationship between different thyroid disorders and dermatological manifestations with a particular focus on the pediatric population. Common cutaneous conditions associated with thyroid dysfunction may include chronic urticaria, vitiligo, and alopecia, which can be early harbingers of an underlying endocrine disruption. This review also highlights the growing cognizance of a "thyroid-skin axis", with thyroid hormones influencing many physiologic processes within the skin such as keratinocyte proliferation, hair growth, and epidermal differentiation. A precocious recognition of abnormal dermatological signs can be crucial in pediatric patients for a timely diagnosis before any development of complications and for personalized treatments of an underlying thyroid disorder, which can even be symptomless at an initial phase. Despite the lack of standardized guidelines for managing dermatologic manifestations occurring in thyroid diseases, a regular screening to identify endocrine dysfunction is recommended in those children who present chronic urticaria, vitiligo, or alopecia, though further research is needed to decipher mechanisms involved in the thyroid-skin partnership and develop more targeted management approaches.
甲状腺功能在儿童的生长发育中起着至关重要的作用,干扰甲状腺激素生物合成、运输和代谢的信号通路改变可能会影响此类患者的皮肤:本综述探讨了不同甲状腺疾病与皮肤表现之间的关系,特别关注儿科人群。与甲状腺功能障碍相关的常见皮肤疾病可能包括慢性荨麻疹、白癜风和脱发,这些可能是潜在内分泌紊乱的早期先兆。本综述还强调了对“甲状腺-皮肤轴”的认识不断增加,甲状腺激素影响皮肤内的许多生理过程,如角质形成细胞增殖、毛发生长和表皮分化。对于儿科患者来说,早熟识别异常皮肤体征对于在并发症发生之前及时诊断以及对潜在甲状腺疾病进行个性化治疗至关重要,而潜在甲状腺疾病在初始阶段甚至可能没有症状。尽管缺乏管理甲状腺疾病中出现的皮肤表现的标准化指南,但对于那些出现慢性荨麻疹、白癜风或脱发的儿童,建议定期筛查以确定内分泌功能障碍,不过需要进一步研究来解读甲状腺与皮肤关系中涉及的机制并开发更有针对性的管理方法。