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Biomedical subjects

J G Dietrich

Publications and source records attributed to J G Dietrich.

7 recordsLinked to original sources
PubMed1986

Acanthosis nigricans, hypothyroidism, and insulin resistance.

Acanthosis nigricans has been associated with multiple endocrinopathies. The common denominator appears to be insulin resistance. Three patients are described (one woman and two men) who presented with hypothyroidism and acanthosis nigricans. All the patients had elevated insulin levels in the fasting state and in response to an oral glucose load. The mechanism for the resistance to insulin was a post-receptor binding defect or a structural abnormality in circulating insulin, since glucose tolerance and plasma cortisol, somatomedin, growth hormone, and insulin receptor concentrations in peripheral monocytes were all normal. Antibodies to insulin or the insulin receptor were absent. Neither insulin resistance nor acanthosis nigricans diminished following correction of the hypothyroidism. It is concluded that hypothyroidism may be associated with acanthosis nigricans, that hyperinsulinemia is a regular correlate of the skin disorder, and that treatment of the hypothyroidism does not resolve the hyperinsulinemia or the acanthosis nigricans.

Acanthosis Nigricans↗
PubMed1984

Histochemical evaluation of glycosaminoglycan deposition in the skin.

Histologic demonstration of glycosaminoglycan (GAG) deposition in the skin has been based on the use of either colloidal iron or alcian blue. To define the best technique for the determination of skin GAG content we undertook a prospective study comparing the two stains and evaluating the use of cetylpyridinium chloride (CPC) to enhance fixation. Slides were prepared from skin biopsies obtained from five patients with cutaneous mucinoses. The preparations were coded and examined by three observers. Colloidal iron staining gave a higher intensity for GAG deposits in papillary and reticular dermis. Digestion by specific enzymes identified similar GAGs with either colloidal iron, or alcian blue; however, colloidal iron made GAGs more obvious, partly due to the contrast afforded by the yellow background stain. The addition of CPC to the fixative appreciably enhanced GAG fixation without interfering with the action of enzymes. Experimentally, we confirmed this effect of CPC by determining a pronounced decrease in GAG leakage into the fixative from CPC treated human umbilical cord. We conclude that the combination of CPC fixation and colloidal iron staining gives the best definition of skin GAGs in clinical specimens.

Acromegaly↗
PubMed1984

The acquired cutaneous mucinoses.

Glycosaminoglycan (GAG) infiltration of the skin is a feature of hyperthyroidism, hypothyroidism, pretibial myxedema, scleromyxedema, and scleredema. We investigated the pathogenesis of the GAG deposits using light microscopy, histochemical digestion with a series of GAG-specific enzymes, and electron microscopy. Hyaluronic acid was the main GAG in all the conditions and in normal skin. Furthermore, there was minimal histologic variability of GAG dermal distribution. A striking distinguishing feature involved dermal fibroblast activity, which appeared normal or inactive in thyroid disorders and hypertrophic and/or hyperplastic in scleromyxedema and scleredema. Thus, the acquired cutaneous mucinoses exhibit similar skin GAG distribution and biochemical composition. The morphologic differences in fibroblastic activity suggest that the mucinoses of scleredema and scleromyxedema represent a local process, whereas the GAG infiltration of thyroid diseases may have a systemic origin.

Adult↗
PubMed1983

Glycosaminoglycan deposition in the acanthosis nigricans lesions of the polycystic ovary syndrome.

Skin biopsy specimens of acanthosis nigricans (AN) lesions were obtained from seven women with the polycystic ovary (PCO) syndrome and insulin resistance (IR). All the patients had normal thyroid function test results and fasting hyperinsulinemia with an exaggerated insulin response to oral glucose. Acanthosis nigricans lesions exhibited prominent deposits of glycosaminoglycan (GAG) consisting mostly of hyaluronic acid in the papillary dermis. Normal amounts of GAGs were found in control biopsy specimens obtained from areas of the skin not involved by AN and from skin of the nape of the neck or axillae in three normal women. These studies demonstrate that GAG deposition is a regular component of AN skin in patients with PCO and IR. The cause of these infiltrates remains to be determined.

Acanthosis Nigricans↗