What is Endocrinology - How does ageing affect how much you weigh?
The endocrine milieu may have an impact on significant changes in body composition that are linked to ageing and may have significant endocrine and metabolic repercussions. Body weight increases until around age 55 and then starts to fall, according to cross-sectional studies. This could be a result of the heaviest patients dying off in middle life. Prospective studies indicate that around the age of 65 to 70, weight really decreases. Whether deliberate or accidental, this loss of body weight seems to be linked to a rise in mortality, illness, and disability. In fact, there is a well-documented obesity paradox in elderly individuals, where the shift in the weight associated with the lowest overall mortality. The reason for this is unclear, but considering that purposeful weight loss is challenging to maintain, it's plausible that any prolonged weight loss may actually be accidental. When cytokine levels are elevated by illness or disease, weight loss may be predisposed to a disproportionate loss of lean mass (muscle mass), aggravating age-related "sarcopenia" and resulting in a catabolic condition. The apparent obesity paradox of ageing may possibly be due to the heterogeneity of obesity in older people; obesity that develops in adolescence or middle age is more hazardous than obesity that develops in later life. It may also be assumed that interventions in these two potentially varied groups may have different outcomes, but this has not been researched.
What is Endocrinology - Does obesity worsen any skin conditions?
Yes. Numerous skin conditions, such as intertrigo, hidradenitis suppurativa, cellulite, psoriasis, and chronic venous insufficiency are made worse by obesity. Obesity also makes skin diseases caused by bacteria worse. These include everything from folliculitis, which is a superficial infection, to necrotizing fasciitis and cellulitis, which are deep infections.
What is Endocrinology - What are a few of the cutaneous symptoms of obesity?
Obese people experience a wide range of cutaneous symptoms, such as insulin resistance-related alterations as well as inflammatory, mechanical, and viral diseases. These include acrochordons (skin tags), acanthosis nigricans (described previously), keratosis pilaris, striae distensae, and hidradenitis suppurativa.
What is Endocrinology - What impact does obesity have on the physiology and function of the skin? Obesity has numerous implications on the physiology and function of the skin. Obese people have different skin barrier functions and much more transepidermal water loss. Increased sebaceous gland activity and sebum production are linked to elevated levels of androgens, insulin, growth hormone, and insulin-like growth factor in obese patients, aggravating conditions like acne vulgaris. Patients who are fat also have more active apocrine and eccrine sweat glands. Obese people have impaired lymphatic flow, which causes a buildup of protein-rich lymphatic fluid in the subcutaneous tissue and lymphedema. Obesity has been linked in animal studies to altered collagen structure and function as well as decreased wound healing.
What is Endocrinology - What cutaneous symptoms of hyperthyroidism exist?
According to studies, up to 97% of all hyperthyroidism patients experience skin symptoms. Skin erythema, evanescent flushing, excoriations, smoothness, hyperpigmentation, moisture from increased perspiration, pretibial myxedema, pruritus (itching), and warmth are typical cutaneous signs. Nails might separate from the underlying bed because they are frequently fragile (onycholysis). Additionally, the hair may be thinner than usual.
What is Endocrinology - What is the treatment for pretibial myxedema?
There are no studies that contrast various treatment regimens. Treatment is not always necessary because the illness doesn't harm people and because it sometimes goes away on its own. Numerous patients react to intralesional or powerful topical corticosteroids that are occluded. Rituximab or oral systemic corticosteroids along with plasmapheresis may be used to treat more severe instances. The cutaneous findings are not affected by thyroid disease treatment.
What is Endocrinology - What clinical symptoms does pretibial myxedema present with? Approximately 3% to 5% of Graves' disease patients experience pretibial myxedema. Most patients experience exophthalmos that is related. One percent of Graves' disease patients also have thyroid acropachy. Pretibial myxedema is clinically characterised by edematous, indurated plaques over the pretibial areas, while it is possible that other body sites are also affected. Although diffuse forms have sometimes been recorded, the plaques are typically clearly defined. Although it may be dotted with smaller papules, the skin's top layer is often normal. From skin-colored to brownish red, the colour ranges. Rarely, underlying hypertrichosis may be present. Pretibial myxedema histologically exhibits a significant buildup of cutaneous hyaluronic acid.
What is Endocrinology -What distinguishes pretibial myxedema from generalised myxedema? Pretibial myxedema is a defining feature of Graves' illness, whereas generalised myxedema is only connected to the hypothyroid condition. When the skin condition manifests, patients with pretibial myxedema may be hypothyroid, hyperthyroid, or euthyroid. Although the pathophysiology has not been established, it has been shown that serum from pretibial myxedema patients would increase the fibroblasts' ability to produce acid mucopolysaccharides. Pretibial areas typically have these lesions because the fibroblasts there are more responsive to stimulation than those in other regions, which explains why. Stimulatory thyroid-stimulating hormone (TSH) receptor autoantibodies are considered to be the most likely option for this circulating component despite the fact that its exact nature is unknown. Researchers have also proposed that activated T lymphocytes cause fibroblast growth and acid mucopolysaccharide formation.
What is Endocrinology - What is the generalised myxedema pathogenesis?
The skin exhibits an increased buildup of dermal acid mucopolysaccharides, the most significant of which is hyaluronic acid (ground substance). Studies have also shown that the appearance of edoema is exacerbated by an enhanced transcapillary escape of serum albumin into the dermis. Both of these alterations can be reversed with replacement therapy; neither is permanent.
What is Endocrinology - What clinical symptoms are present in widespread myxedema?
The skin of those with generalised myxedema is pale, waxy, and edematous and does not show pitting. The periorbital region is where these changes are most obvious, but they can also be seen in the distal extremities, lips, and tongue.
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