Skin lesions in patients treated with growth hormone and those with growth hormone excess: a current overview

Growth hormone (GH) is an ancestral hormone secreted from the anterior pituitary gland. In adulthood, it is essential to regulate metabolism. GH synthesis and secretion are regulated in a complex manner, primarily through the actions of hypothalamic neuropeptides (GHRH and somatostatin) that integrate hormonal, metabolic, and neurogenic signals. Currently, recombinant human GH is widely used to treat growth hormone deficiency (GHD) and numerous non-GHD disorders, such as short stature and catabolic conditions. Conversely, an excess of GH may lead to different and severe conditions, such as acromegaly, gigantism, Carney complex, McCune-Albright syndrome, neurofibromatosis, and multiple endocrine neoplasia type 1. In patients with growth hormone excess disorders or those treated with GH, skin manifestations are common and can include skin thickening, coarsened facial features, skin tags, oily skin, and excessive sweating. These dermatological changes result from the direct actions of GH and IGF-1 (insulin-like growth factor 1) on skin cells and appendages, leading to increased collagen synthesis and connective tissue expansion. This review focuses on the various skin symptoms associated with these disorders caused by GH excess. This narrative review summarizes recent findings on the management of skin lesions in GH-treated patients and in those with GH excess, highlighting the benefits, side effects, and limitations of current therapies.