Effects of Growth Hormone (GH) Supplementation on Dermatoscopic Evolution of Pigmentary Lesions in Children with Growth Hormone Deficiency (GHD)

Fabrizio Panarese,Nella Polidori,Cosimo Giannini,Federica Giuliani,Giulio Gualdi,Paolo Amerio,Marta Di Nicola,Angelika Mohn

doi:10.3390/jcm11030736

Fabrizio Panarese, Nella Polidori + Show 6 more

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https://doi.org/10.3390/jcm11030736

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Abstract

Recent reports have confirmed higher levels of growth hormone (GH) receptor (GHR) transcripts in malignant melanomas (MM), yet the role of GH in the pathogenesis of MM remains controversial. Although melanocytes appear to be hormonally responsive, the effects of GH on MM cells are less clear. A direct correlation between GH administration and the development of melanoma seems possible. Our study aimed to assess whether GH supplementation in children with growth hormone deficiency (GHD) could induce changes in the melanocytic lesions both from a dimensional and dermoscopic point of view. The study population consisted of 14 patients sorted into two groups. The experimental group consisted of seven GHD pediatric patients who underwent dermatological examination with epiluminescence through the use of digital video recording of all melanocytic lesions before and after 12 months of GH supplementation, whilst the control group consisted of seven healthy pediatric patients matched for age, sex and phototype. All patients were evaluated according to auxological and dermatological features. A total of 225 melanocytic lesions were examined in the experimental group and 236 in the control group. Our study shows a significant increase in the mean size values of the lesions in the study group but not in the control group. Increases in the dermoscopic ABCD Score and in BMI correlated to an increase in the size of the melanocytic lesions and the dermoscopic parameters. The increase in SDS Height correlated with ABCD Score changes and with dermoscopic score structures. No differences were found compared to the control group. Dimensional/structural modifications in melanocytic lesions of patients treated with GH were closely related to weight and statural growth and can be considered a normal physiological process induced by GH supplementation.

Highlights

Melanoma originates from melanocytes that have switched to cancerous cells as a consequence of aberrant changes at molecular and biochemical levels [1]
The first identification of growth hormone receptor (GHR) RNA in human skin melanocyte cells dates back more than 20 years [17] and has been followed by the discovery of autocrine levels of GH and IGF1, present in normal skin and basal cell carcinoma [17,18]
In primary human melanoma samples, an elevated expression of the GH-releasing hormone receptor (GHRH) (GHRHR) has been demonstrated [25], while GHRH analogues have been shown to suppress the growth of malignant melanomas in vivo [26]

Summary

Introduction

Melanoma originates from melanocytes that have switched to cancerous cells as a consequence of aberrant changes at molecular and biochemical levels [1]. Melanoma is characterized by an extensive degree of heterogeneity in terms of clinical, dermatological and histopathological presentation [2]; genomic and post-genomic profiles [3,4,5,6]; and risk factors (skin type, exposure to sun radiation, number of nevi, age, gender, immune status, family history or history of previously removed melanomas). This tumor is characterized by a high propensity to metastasize [7,8], making this disorder a significant public health issue. In primary human melanoma samples, an elevated expression of the GH-releasing hormone receptor (GHRH) (GHRHR) has been demonstrated [25], while GHRH analogues have been shown to suppress the growth of malignant melanomas in vivo [26]

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