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Gender Dermatology: Pigmentation Disorders

  • Mor Pavlovsky
Chapter

Abstract

The fact that men and women are genetically different goes without saying. How does this factor affect various aspects of skin pigmentation is an extensive area of study.

This chapter will focus on gender influence on skin pigmentation in health and disease.

In health, the influence of sex hormones on melanocyte homeostasis and melanogenesis will be discussed.

In disease: disorders that cause altered skin tone will be discussed, that are not a part of a known dermatologis condition.

Vitiligo is a prototype of hypopigmentation disorders. Even though no difference in incidence of vitiligo exist between men and women, the quality of life impairment in women affected with vitiligo is greater than that in men with same disease severity. Other disorders of hypopigmenation will be discussed briefly.

Melasma is a prototype of hyperpigmanation disorders.

When talking about gender differences in dermatology, melasma is one of the firs conditions to be discussed because of its much higher prevalence among women. There are some features of melasma in men that seem to different. These differences and other disorders of hyperpigmenataion will be discussed in this chapter.

In summary, better understanding of gender differences in skin pigmentation can shed a new light on the pathogenesis of pigmentation disorders and aid in discovering a more effective treatment.

Keywords

Pigmentation Melanocyte Melanin Vitiligo Melasma Skin tone 

References

  1. 1.
    Friedmann PS, Gilchrest BA. Ultraviolet radiation directly induces pigment production by cultured human melanocytes. J Cell Physiol. 1987;133(1):88–94.CrossRefGoogle Scholar
  2. 2.
    Pears JS, Jung RT, Bartlett W, Browning MC, Kenicer K, Thody AJ. A case of skin hyperpigmentation due to alpha-MSH hypersecretion. Br J Dermatol. 1992;126(3):286–9.CrossRefGoogle Scholar
  3. 3.
    Ranson M, Posen S, Mason RS. Human melanocytes as a target tissue for hormones: in vitro studies with 1 alpha-25, dihydroxyvitamin D3, alpha-melanocyte stimulating hormone, and beta-estradiol. J Invest Dermatol. 1988;91(6):593–8.CrossRefGoogle Scholar
  4. 4.
    McLeod SD, Ranson M, Mason RS. Effects of estrogens on human melanocytes in vitro. J Steroid Biochem Mol Biol. 1994;49(1):9–14.CrossRefGoogle Scholar
  5. 5.
    Jee SH, Lee SY, Chiu HC, Chang CC, Chen TJ. Effects of estrogen and estrogen receptor in normal human melanocytes. Biochem Biophys Res Commun. 1994;199(3):1407–12.CrossRefGoogle Scholar
  6. 6.
    Kim NH, Cheong KA, Lee TR, Lee AY. PDZK1 upregulation in estrogen-related hyperpigmentation in melasma. J Invest Dermatol. 2012;132(11):2622–31.CrossRefGoogle Scholar
  7. 7.
    Jian D, Jiang D, Su J, Chen W, Hu X, Kuang Y, et al. Diethylstilbestrol enhances melanogenesis via cAMP-PKA-mediating up-regulation of tyrosinase and MITF in mouse B16 melanoma cells. Steroids. 2011;76(12):1297–304.CrossRefGoogle Scholar
  8. 8.
    Kippenberger S, Loitsch S, Solano F, Bernd A, Kaufmann R. Quantification of tyrosinase, TRP-1, and Trp-2 transcripts in human melanocytes by reverse transcriptase-competitive multiplex PCR—regulation by steroid hormones. J Invest Dermatol. 1998;110(4):364–7.Google Scholar
  9. 9.
    Wiedemann C, Nagele U, Schramm G, Berking C. Inhibitory effects of progestogens on the estrogen stimulation of melanocytes in vitro. Contraception. 2009;80(3):292–8.CrossRefGoogle Scholar
  10. 10.
    Tadokoro T, Rouzaud F, Itami S, Hearing VJ, Yoshikawa K. The inhibitory effect of androgen and sex-hormone-binding globulin on the intracellular cAMP level and tyrosinase activity of normal human melanocytes. Pigment Cell Res. 2003;16(3):190–7.CrossRefGoogle Scholar
  11. 11.
    Whiteman DC, Parsons PG, Green AC. Determinants of melanocyte density in adult human skin. Arch Dermatol Res. 1999;291(9):511–6.CrossRefGoogle Scholar
  12. 12.
    Giacomoni PU, Mammone T, Teri M. Gender-linked differences in human skin. J Dermatol Sci. 2009;55(3):144–9.CrossRefGoogle Scholar
  13. 13.
    Mehrai H, Sunderland E. Skin colour data from Nowshahr City, northern Iran. Ann Hum Biol. 1990;17(2):115–20.CrossRefGoogle Scholar
  14. 14.
    Banerjee S. Pigmentary fluctuation and hormonal changes. J Genet Hum. 1984;32(5):345–9.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Roh K, Kim D, Ha S, Ro Y, Kim J, Lee H. Pigmentation in Koreans: study of the differences from caucasians in age, gender and seasonal variations. Br J Dermatol. 2001;144(1):94–9.CrossRefGoogle Scholar
  16. 16.
    Green A, Martin NG. Measurement and perception of skin colour in a skin cancer survey. Br J Dermatol. 1990;123(1):77–84.CrossRefGoogle Scholar
  17. 17.
    Kalla AK, Tiwari SC. Sex differences in skin colour in man. Acta Genet Med Gemellol. 1970;19(3):472–6.CrossRefGoogle Scholar
  18. 18.
    Kalla AK. Ageing and sex differences in human skin pigmentation. Z Morphol Anthropol. 1973;65(1):29–33.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Tur E. Physiology of the skin—differences between women and men. Clin Dermatol. 1997;15(1):5–16.CrossRefGoogle Scholar
  20. 20.
    Kelly RI, Pearse R, Bull RH, Leveque JL, de Rigal J, Mortimer PS. The effects of aging on the cutaneous microvasculature. J Am Acad Dermatol. 1995;33(5 Pt 1):749–56.CrossRefGoogle Scholar
  21. 21.
    Frost P. Human skin color: a possible relationship between its sexual dimorphism and its social perception. Perspect Biol Med. 1988;32(1):38–58.CrossRefGoogle Scholar
  22. 22.
    Ortonne JP. Normal and abnormal skin color. Ann Dermatol Venereol. 2012;139(Suppl 4):S125–9.CrossRefGoogle Scholar
  23. 23.
    Picardo M, Dell’Anna ML, Ezzedine K, Hamzavi I, Harris JE, Parsad D, et al. Vitiligo. Nat Rev Dis Primers. 2015;1:15011.CrossRefGoogle Scholar
  24. 24.
    Ngo ST, Steyn FJ, McCombe PA. Gender differences in autoimmune disease. Front Neuroendocrinol. 2014;35(3):347–69.CrossRefGoogle Scholar
  25. 25.
    Jin Y, Andersen G, Yorgov D, Ferrara TM, Ben S, Brownson KM, et al. Genome-wide association studies of autoimmune vitiligo identify 23 new risk loci and highlight key pathways and regulatory variants. Nat Genet. 2016;48(11):1418–24.CrossRefGoogle Scholar
  26. 26.
    Howitz J, Brodthagen H, Schwartz M, Thomsen K. Prevalence of vitiligo. Epidemiological survey on the Isle of Bornholm, Denmark. Arch Dermatol. 1977;113(1):47–52.CrossRefGoogle Scholar
  27. 27.
    Kyriakis KP, Palamaras I, Tsele E, Michailides C, Terzoudi S. Case detection rates of vitiligo by gender and age. Int J Dermatol. 2009;48(3):328–9.CrossRefGoogle Scholar
  28. 28.
    Patil S, Gautam M, Nadkarni N, Saboo N, Godse K, Setia MS. Gender differences in clinicoepidemiological features of vitiligo: a cross-sectional analysis. ISRN Dermatol. 2014;2014:186197.CrossRefGoogle Scholar
  29. 29.
    Talsania N, Lamb B, Bewley A. Vitiligo is more than skin deep: a survey of members of the Vitiligo Society. Clin Exp Dermatol. 2010;35(7):736–9.CrossRefGoogle Scholar
  30. 30.
    Ongenae K, Van Geel N, De Schepper S, Naeyaert JM. Effect of vitiligo on self-reported health-related quality of life. Br J Dermatol. 2005;152(6):1165–72.CrossRefGoogle Scholar
  31. 31.
    Borimnejad L, Parsa Yekta Z, Nikbakht-Nasrabadi A, Firooz A. Quality of life with vitiligo: comparison of male and female muslim patients in Iran. Gend Med. 2006;3(2):124–30.CrossRefGoogle Scholar
  32. 32.
    Kleck RE, Christopher Strenta A. Gender and responses to disfigurement in self and others. J Soc Clin Psychol. 1985;3(3):257–67.CrossRefGoogle Scholar
  33. 33.
    Vachiramon V, Thadanipon K. Postinflammatory hypopigmentation. Clin Exp Dermatol. 2011;36(7):708–14.CrossRefGoogle Scholar
  34. 34.
    Miazek N, Michalek I, Pawlowska-Kisiel M, Olszewska M, Rudnicka L. Pityriasis alba—common disease, enigmatic entity: up-to-date review of the literature. Pediatr Dermatol. 2015;32(6):786–91.CrossRefGoogle Scholar
  35. 35.
    Blessmann Weber M, Sponchiado de Avila LG, Albaneze R, Magalhaes de Oliveira OL, Sudhaus BD, Cestari TF. Pityriasis alba: a study of pathogenic factors. J Eur Acad Dermatol Venereol. 2002;16(5):463–8.CrossRefGoogle Scholar
  36. 36.
    Relyveld GN, Menke HE, Westerhof W. Progressive macular hypomelanosis: an overview. Am J Clin Dermatol. 2007;8(1):13–9.CrossRefGoogle Scholar
  37. 37.
    Juntongjin P, Laosakul K. Idiopathic guttate hypomelanosis: a review of its etiology, pathogenesis, findings, and treatments. Am J Clin Dermatol. 2016;17(4):403–11.CrossRefGoogle Scholar
  38. 38.
    Kim SK, Kim EH, Kang HY, Lee ES, Sohn S, Kim YC. Comprehensive understanding of idiopathic guttate hypomelanosis: clinical and histopathological correlation. Int J Dermatol. 2010;49(2):162–6.CrossRefGoogle Scholar
  39. 39.
    Grimes PE. Melasma. Etiologic and therapeutic considerations. Arch Dermatol. 1995;131(12):1453–7.CrossRefGoogle Scholar
  40. 40.
    Hiletework M. Skin diseases seen in Kazanchis health center. Ethiop Med J. 1998;36(4):245–54.PubMedPubMedCentralGoogle Scholar
  41. 41.
    Werlinger KD, Guevara IL, Gonzalez CM, Rincon ET, Caetano R, Haley RW, et al. Prevalence of self-diagnosed melasma among premenopausal Latino women in Dallas and Fort Worth, Tex. Arch Dermatol. 2007;143(3):424–5.CrossRefGoogle Scholar
  42. 42.
    Vazquez M, Maldonado H, Benmaman C, Sanchez JL. Melasma in men. A clinical and histologic study. Int J Dermatol. 1988;27(1):25–7.CrossRefGoogle Scholar
  43. 43.
    Sarkar R, Jain RK, Puri P. Melasma in Indian males. Dermatol Surg. 2003;29(2):204.CrossRefGoogle Scholar
  44. 44.
    Pichardo R, Vallejos Q, Feldman SR, Schulz MR, Verma A, Quandt SA, et al. The prevalence of melasma and its association with quality of life in adult male Latino migrant workers. Int J Dermatol. 2009;48(1):22–6.CrossRefGoogle Scholar
  45. 45.
    Sheth VM, Pandya AG. Melasma: a comprehensive update: part I. J Am Acad Dermatol. 2011;65(4):689–97; quiz 98.CrossRefGoogle Scholar
  46. 46.
    Sarkar R, Puri P, Jain RK, Singh A, Desai A. Melasma in men: a clinical, aetiological and histological study. J Eur Acad Dermatol Venereol. 2010;24(7):768–72.CrossRefGoogle Scholar
  47. 47.
    El-Essawi D, Musial JL, Hammad A, Lim HW. A survey of skin disease and skin-related issues in Arab Americans. J Am Acad Dermatol. 2007;56(6):933–8.CrossRefGoogle Scholar
  48. 48.
    Sialy R, Hassan I, Kaur I, Dash RJ. Melasma in men: a hormonal profile. J Dermatol. 2000;27(1):64–5.CrossRefGoogle Scholar
  49. 49.
    Vachiramon V, Suchonwanit P, Thadanipon K. Melasma in men. J Cosmet Dermatol. 2012;11(2):151–7.CrossRefGoogle Scholar
  50. 50.
    Sanchez NP, Pathak MA, Sato S, Fitzpatrick TB, Sanchez JL, Mihm MC Jr. Melasma: a clinical, light microscopic, ultrastructural, and immunofluorescence study. J Am Acad Dermatol. 1981;4(6):698–710.CrossRefGoogle Scholar
  51. 51.
    Kang WH, Yoon KH, Lee ES, Kim J, Lee KB, Yim H, et al. Melasma: histopathological characteristics in 56 Korean patients. Br J Dermatol. 2002;146(2):228–37.CrossRefGoogle Scholar
  52. 52.
    Jang YH, Sim JH, Kang HY, Kim YC, Lee ES. The histopathological characteristics of male melasma: comparison with female melasma and lentigo. J Am Acad Dermatol. 2012;66(4):642–9.CrossRefGoogle Scholar
  53. 53.
    Fried RG. Esthetic treatment modalities in men: psychologic aspects of male cosmetic patients. Dermatol Ther. 2007;20(6):379–84.CrossRefGoogle Scholar
  54. 54.
    Keeling J, Cardona L, Benitez A, Epstein R, Rendon M. Mequinol 2%/tretinoin 0.01% topical solution for the treatment of melasma in men: a case series and review of the literature. Cutis. 2008;81(2):179–83.PubMedPubMedCentralGoogle Scholar
  55. 55.
    Ikino JK, Nunes DH, Silva VP, Frode TS, Sens MM. Melasma and assessment of the quality of life in Brazilian women. An Bras Dermatol. 2015;90(2):196–200.CrossRefGoogle Scholar
  56. 56.
    Callender VD, St Surin-Lord S, Davis EC, Maclin M. Postinflammatory hyperpigmentation: etiologic and therapeutic considerations. Am J Clin Dermatol. 2011;12(2):87–99.CrossRefGoogle Scholar
  57. 57.
    Combemale P, Faisant M, Guennoc B, Dupin M, Heyraud JD. Erythema dyschromicum perstans: report of a new case and critical review of the literature. J Dermatol. 1998;25(11):747–53.CrossRefGoogle Scholar
  58. 58.
    Tamraz H, Raffoul M, Kurban M, Kibbi AG, Abbas O. Confluent and reticulated papillomatosis: clinical and histopathological study of 10 cases from Lebanon. J Eur Acad Dermatol Venereol. 2013;27(1):e119–23.CrossRefGoogle Scholar
  59. 59.
    Boer A, Misago N, Wolter M, Kiryu H, Wang XD, Ackerman AB. Prurigo pigmentosa: a distinctive inflammatory disease of the skin. Am J Dermatopathol. 2003;25(2):117–29.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mor Pavlovsky
    • 1
  1. 1.Department of DermatologyTel Aviv Sourasky Medical CenterTel AvivIsrael

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