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Hautmanifestationen beim metabolischen Syndrom

Cutaneous manifestations of metabolic syndrome

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Zusammenfassung

Hintergrund

Der Begriff metabolisches Syndrom (MetS) beschreibt die Häufung mehrerer Risikofaktoren, die das Risiko für Herz-Kreislauf-Erkrankungen und Diabetes mellitus Typ II deutlich erhöhen. Arterielle Hypertonie, Hyperglykämie, Dyslipidämie und viszerale Fettleibigkeit sind die Hauptrisikofaktoren. Das MetS ist keine dermatologische Diagnose per se, dennoch können einige Hautmanifestationen Hinweise für ein beginnendes MetS liefern und dadurch eine frühzeitige Diagnose und Therapie ermöglichen, um die Folgeschäden des MetS zu verhindern.

Kutane Manifestationen

Acanthosis nigricans und multiple weiche Fibrome können Zeichen einer Insulinresistenz und pathologischen Glukosetoleranz, Xanthome und Xanthelasmen Zeichen einer Dyslipidämie sein. Patienten mit Typ-II-Diabetes zeigen zahlreiche mehr oder weniger spezifischen Hautveränderungen. Psoriasis und Hidradenitis suppurativa sind häufig mit dem MetS und Adipositas vergesellschaftet. Akne und Hirsutismus sind häufige kutane Androgenisierungserscheinungen im Rahmen eines polyzystischen Ovarsyndroms (PCOS), bei dem Hyperinsulinämie eine zentrale pathogenetische Rolle spielt. Das MetS ist ein integraler Bestandteil des PCOS.

Schlussfolgerung

Die zunehmende Kenntnis enger Zusammenhänge zwischen MetS und häufigen Hauterkrankungen erfordert, diese Perspektive in das therapeutische Management einzubinden. Dem Dermatologen kommt hierbei eine Schlüsselrolle in der frühen Erkennung von Zeichen des MetS zu.

Abstract

Background

Metabolic syndrome (MetS) is a cluster of risk factors which increase the risk of developing cardiovascular diseases and type II diabetes mellitus. High blood pressure, hyperglycemia, dyslipidemia, and central obesity are the main risk factors. While MetS is not a dermatological diagnosis per se, several cutaneous manifestations can serve as a clinical indicator for impending MetS and facilitate an early diagnosis and therapy in order to prevent its long-term sequelae.

Cutaneous manifestations

Acanthosis nigricans and multiple skin tags can be signs of insulin resistance and impaired glucose tolerance, xanthoma and xanthelasma signs of dyslipidemia. Patients with type II diabetes can display numerous more or less specific dermatoses. Psoriasis and Hidradenitis suppurativa are frequently associated with MetS and obesity. Acne and hirsutism are highly prevalent signs of cutaneous hyperandrogenism due to polycystic ovary syndrome (PCOS). Hyperinsulinemia plays a major pathophysiological role in PCOS; MetS is thus an integral part of PCOS

Conclusion

Emerging scientific evidence points to close associations between MetS and common dermatological diseases necessitating to integrate this perspective into clinical management of these diseases. The dermatologist is a key player in early detection of MetS.

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G. Holzer, B. Straßegger und B. Volc-Platzer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben. Im Falle von nicht mündigen Patienten liegt die Einwilligung eines Erziehungsberechtigten oder des gesetzlich bestellten Betreuers vor.

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Holzer, G., Straßegger, B. & Volc-Platzer, B. Hautmanifestationen beim metabolischen Syndrom. Hautarzt 67, 982–988 (2016). https://doi.org/10.1007/s00105-016-3891-2

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