Skin Steroidogenesis in Health and Disease

The document from 2016 reviews the skin's role as an active site of steroid hormone production, known as steroidogenesis, and its implications for various skin conditions. It explains that the skin can synthesize sex steroids and glucocorticoids from cholesterol, which is significant for conditions like acne, rosacea, atopic dermatitis, and androgenic alopecia. The skin has the necessary enzymes to produce these hormones de novo, implicating the pilosebaceous unit in this process. The review also discusses the skin's ability to produce androgens and estrogens, the enzymes involved, and the importance of hormone homeostasis in skin disease pathogenesis. It connects inflammatory signaling to acne vulgaris, altered cortisol production to atopic dermatitis, and corticosteroid homeostasis disturbance to rosacea. The potential role of steroidogenesis in skin cancer and autoimmune progesterone dermatitis is also mentioned. The document concludes that understanding skin steroid homeostasis could lead to new treatments for skin diseases, noting that proteins involved in steroidogenesis are found at higher levels in bald scalp tissue and that the distribution of 5a-reductase varies in different parts of the scalp, affecting hair growth.