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Male fertility and skin diseases
M Badawy Abdel-Naser1,2, Christos C Zouboulis3
1Department of Dermatology, Andrology and STIs, Ain Shams University, 4 Al Rahman Tower, El Sawah Square, Cairo, 11281, Egypt. abdelnasermb@yahoo.com.
Abstract:
Male fertility can be affected by a variety of organs diseases, including the skin. Several genodermatoses affect the skin and several other organs including the male reproductive system, commonly in the form of cryptorchidism and hypogonadism. The most relevant syndromes are associated with dyschromias, such as deSanctis-Cacchione, poikiloderma congenital, LEOPARD, and H syndrome; others with ichthyosis, such as Rud, and trichothiodystrophy; or a group of unrelated genodermatoses, such as ablepharon macrostomia, Coffin-Siris, Gorlin-Goltz, and Werner. Acquired skin diseases may also affect male fertility usually in the form of orchitis or epididymal obstruction or androgen antagonists. These include infections (leprosy and HIV), autoimmune (erythema nodosum leprosum), granulomatous (sarcoidosis, Langerhans cell histiocytosis), nutritional deficiency (zinc), and malignancy. Several therapeutics of skin diseases are notorious for their effects on male fertility, most notably are the cytotoxic drugs (methotrexate), irradiation, and antiandrogens (spironolactone, finasteride). Although the prevalence of these skin diseases is low, the associated male infertility represents a challenge due to the difficulty of its management. Clinical management of the skin diseases should include consideration of their effects not only on the diseases but also on the male reproductive system.
Insights
Skin diseases, both inherited (genodermatoses) and acquired, can significantly impact male fertility through various mechanisms. Managing these conditions requires careful consideration of effects on the male reproductive system.
Area of Science:
- Dermatology
- Reproductive Medicine
- Genetics
Background:
- Skin diseases encompass a range of genodermatoses and acquired conditions.
- Several genodermatoses impact male reproductive organs, causing cryptorchidism and hypogonadism.
- Acquired dermatological conditions like infections, autoimmune disorders, and malignancies can also impair male fertility.
Purpose of the Study:
- To review the impact of genodermatoses and acquired skin diseases on male fertility.
- To highlight specific syndromes and conditions affecting male reproductive health.
- To discuss the implications of skin disease therapeutics on male fertility.
Main Methods:
- Literature review of genodermatoses and acquired skin diseases affecting male fertility.
- Categorization of conditions based on etiology (genetic vs. acquired) and clinical presentation.
- Analysis of common mechanisms of infertility, including orchitis, obstruction, and hormonal disruption.
Main Results:
- Genodermatoses like deSanctis-Cacchione, poikiloderma congenital, H syndrome, Rud syndrome, and trichothiodystrophy are linked to male infertility.
- Acquired conditions such as leprosy, HIV, sarcoidosis, and zinc deficiency can lead to orchitis or epididymal obstruction.
- Therapeutics like methotrexate, irradiation, and antiandrogens (spironolactone, finasteride) adversely affect male fertility.
Conclusions:
- Skin diseases, though often rare, pose a significant challenge to male reproductive health.
- Management of skin conditions must integrate assessment and care for the male reproductive system.
- Further research is needed to understand and mitigate the fertility impacts of dermatological disorders and their treatments.
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