Reduce Sebum Production Naturally
Voice mutation will not occur. The frontal hairline will remain straight without lateral recession, beard growth is absent or scanty, the pubic hairline remains straight. Hemoglobin and erythrocytes will be in the lower normal to subnormal range. Early development of fine perioral and periorbital wrinkles are characteristic. Muscles remain underdeveloped. The skin is dry due to lack of sebum production and free of acne. The penis remains small, the prostate is underdeveloped. Spermatogenesis will not be initiated and the testes remain small. If an ejaculate can be produced it will have a very small volume. Libido and potency will not develop. A lack of testosterone occurring in adulthood cannot change body proportions, but will result in decreased bone mass and osteoporosis. Early-on lower backache and, at an advanced stage, vertebral fractures may occur. Once mutation has occurred the voice will not change again. Lateral hair recession and baldness...
Skin - the largest organ in the body provides protection as the external covering of the body. The sebaceous glands produce sebum, which creates an acid surface pH that prevents replication of pathogenic bacteria while creating an environment for the survival of normal commensal bacteria. Sweat glands release sweat, which contains lysozymes with antibacterial properties
The sympathetic trunk (chain) ascends from the thorax into the cervical region, within the prevertebral fascia along the longus colli and longus capitis muscles (Figure 25-5C). The sympathetic trunk in the cervical region receives only gray rami communicantes (no white rami). The sympathetic trunk innervates the sweat and sebaceous glands, blood vessels, and the errector pili, dilator pupillae, and superior tarsal muscles.
Seborrheic dermatitis is a chronic inflammatory disorder affecting areas of the head (scalp, face) and body where sebaceous glands are prominent. The inflammation is thought to be caused by Malassezia (Pityrosporum) species. All age groups may be affected, and seborrhea can be chronic or intermittent. On the scalp, seborrhea can range from mild dandruff to thick, adherent plaques. Seborrhea on the face and body appears as greasy scales in skin folds and along hair margins, with a symmetric distribution bilaterally. On the face, two common locations are around the eyebrows and around the beard and mustache in men (Fig. 33-16 and 33-17)
All of these movement disorders can be part of Parkinson's disease. The bradykinesia shows up as a delay in the execution and initiation of voluntary movement, and also there is difficulty arresting the movement once it has been started. Akinesia is simply an extreme state of immobility, and some Parkinson's patients, particularly before treatment with levodopa became available, eventually ended their days totally rigid and immobilized. Rigidity is resistance to passive stretch of muscle, and the patients with parkinsonism have a characteristic stiffness of the muscles of the body. This stiffness can be brought out by passive rotation of the wrist or flexion-extension at the forearm. It is also present in the truncal muscles and can be examined by placing one's hands on the dorsal aspect of the patient's back muscles and having the patient flex and extend the body at the waist. The rigidity that is characteristic of parkinsonism is the rigidity that usually...
Men with 5a-reductase deficiency also contribute to our understanding because they exhibit axillary and female pattern pubic hair, but very little beard growth they are not reported to have male pattern baldness either (Griffin and Wilson 1989) (Fig. 6.3). A role for 5a-reductase in male pattern baldness is also supported by the ability of oral finasteride, a 5a-reductase type 2 inhibitor, to promote hair regrowth (Kaufman et al. 1998 Shapiro and Kaufman 2003). This suggests that the formation of terminal pubic and axillary hair can be mediated by testosterone itself, while that of the secondary sexual hair of men requires the presence of 5a-dihydrotestosterone. This demonstrates a third paradox in androgen effects on hair follicles. Why does the stimulation of increasing size in some follicles e.g. beard require 5a-dihydrotestosterone formation, while follicles in the axillary and pubic regions carry out the same changes in the absence of 5a-dihydrotestosterone Since androgens are...
Figure 18-11 shows ectopic sebaceous glands on the shaft of the penis. The glands appear as pinhead-sized, whitish-yellow papules. These are commonly seen in normal men on the corona, the inner foreskin, and the shaft of the penis. Their appearance is very similar to Fordyce's spots of the oral mucosa (see Fig. 12-18). Ectopic sebaceous glands also may be found in normal women on the labia minora and labia majora (see Fig. 19-13).
The labia minora may show wide variation in size and shape they may be asymmetric. On occasion, yellowish-white, asymptomatic papules may be seen over the inner labia minora. These are called Fordyce's spots and are normal they represent ectopic sebaceous glands. Figure 19-13 shows Fordyce's spots. Ectopic sebaceous glands are also common in the mouth (see Fig. 12-18) and on the shaft of the penis (see Fig. 18-11).
Epidermoid and dermoid cysts are the most common tumors, accounting for up to 60 of the calvarial masses in the pediatric population.52,72 The lesions result when cutaneous ecto-dermal rests are included in the developing cranium. They grow within the diploe and expand and erode the outer and inner tables of the skull. Both epidermoid and dermoid cysts are lined by stratified squamous epithelium and contain keratin from desquamation. Because a dermoid also has skin appendages, its cyst may contain hair and sebum as well. Because the primitive ectoderm has the capacity to form all the epidermal and dermal elements, these cysts embryologically can all be der-moids. Some reports, especially in the older literature, do not differentiate between epidermoid and dermoid cysts. Also, the tissue sent for histopathologic examination may not reflect the lesion in its entirety, or the dermal elements may have been destroyed by inflammation.
Separate studies were conducted with a type 1-selective 5aR inhibitor to determine utility of this mechanism of action, which differs from that of finasteride in inhibiting the alternate isoenzyme of 5aR, in the treatment of clinical disorders. Based on the known stimulation of acne by androgens (Hamilton 1941) and tissue localization of the type 1 isoenzyme (Harris et al. 1992 Thiboutot et al. 1995), which is prominent in sebaceous glands of the skin, a potential target for intervention was in the treatment of patients with acne vulgaris. 18.8.1 Effects on serum and sebum DHT Studies conducted in normal volunteers confirmed that the type 1-selective 5aR inhibitor, MK-386 (Merck & Co., Inc.) (Fig. 18.6), reduced serum DHT concentrations by approximately 30 when administered once daily orally (Ellsworth etal. 1996 Schwartz etal. 1996). Oral administration ofMK-386 also reduced sebum DHT concentrations by approximately 50 , based on a standardized, validated method for measuring sebum...
Microscopically, intraspinal dermoid cysts are lined by simple squamous epithelium and include dermis that may contain hair follicles, hair, sebaceous glands, oil, and other skin appendages indicative of dermal inclusion. Epidermoids are lined by compound squamous epithelium and grow via the accumulation of keratin.29
Uterus and proliferation of endometrium. In addition, estra-diol enhances development of, and increase in, the ducts of the breast and body fat. Estrogen in low levels enhances linear growth, and high levels increase the rate of fusion of epiphy-ses. Testosterone is responsible for the increase in muscle mass, sebaceous glands, and voice changes seen in pubertal males and is a linear growth accelerator. In females, testosterone accelerates linear growth and stimulates pubic and axillary hair development. Progesterone in females is responsible for development of a secretory endometrium and plays a role in breast development. Linear growth and pubic hair development in both males and females are caused by androgens from the adrenal gland. Figures 35-5 and 35-6 show normal pubertal developmental stages of Marshall and Tanner.
Rhinophyma is a common condition in which there is prominent hypertrophy of the sebaceous glands of the nose with overgrowth of the soft tissue. This condition is more common in men than in women. The patient pictured in Figure 11-20 also has acne rosacea, which is a common associated condition consisting of papules, pustules, and erythema of the face. The cause is unknown. The rash is worsened by hot drinks, highly spiced food, and alcohol.
The term acne refers to a group of disorders characterised by abnormalities of the sebaceous glands. Acne vulgaris is the most common condition and is characterised by polymorphous lesions, including comedones (blackheads), inflammatory lesions such as papules or pustules, and scars, affecting the face and less frequently the back and shoulders. A combination of factors are considered as pathogenetic, including the hormonal influence of androgens, seborrhea, abnormalities in the bacterial flora with overgrowth of Propionibacterium Acnei, and plugging of pilosebaceous openings. Mild degrees of acne
The dermis is rich in blood vessels, lymphatic vessels, and nerve endings. An extensive capillary network connects to the systemic circulation with substantial horizontal branching from the arterioles and venules in the papillary dermis. These in turn form plexus and supply capillaries to the hair follicles and the glands. The lymphatic vessels serve to drain the excess extracellular fluid and clear the antigenic materials. The dermis is filled with scattered fibroblasts, macrophages, leukocytes, and mast cells, in addition to the hair follicles, sebaceous glands, and sweat glands. On average, about 10 hair follicles, 15 sebaceous glands, 12 nerves, 100 sweat glands, 360 cm of nerves, and three blood vessels are present in one square centimeter of skin (Barry, 1983). The hypodermis constitutes the deepest layer of the skin, and consists of the subcutaneous tissue filled with fat cells, fibroblasts, and macrophages.
Open comedo or blackhead a plugged follicle of sebum, keratinocytes, and bacteria that protrudes from the surface of the skin and appears black or brown in color. Although dark in color, blackheads do not indicate the presence of dirt, but rather, an accumulation of melanin. Closed comedo or whitehead a plugged follicle of sebum, keratinocytes, and bacteria that remains beneath the surface of the skin. Closed comedos usually appear as small white bumps about 1 to 2 mm in diameter.
The intrinsic pathway of thrombin formation is launched when vascular disruption brings plasma into contact with certain negatively charged substances, such as subendothelial structures or the oily sebum layer of skin. Exposure to negative charges changes a plasma protein, Hageman factor (factor XII), to an enzymatic form, activated Hageman factor (factor XHa), that participates in both clotting and inflammatory reactions. In the latter role, activated Hageman factor converts a plasma proenzyme, prekallikrein, to kallikrein, an enzyme that releases small peptides from a plasma protein, high molecular weight kininogen. These peptides, notably
The eyelids and eyelashes protect the eyes. The eyelids cover the globe and lubricate its surface. The meibomian glands, which are modified sebaceous glands in the eyelids, secrete an oily lubricating substance to retard evaporation. The openings of these glands are at the lid margins.
Small, pinhead-sized, yellow papules on the buccal mucous membrane are usually Fordyce's spots or granules. Fordyce's spots are normal, prominent, ectopic sebaceous glands commonly seen on the lips or buccal mucosa near the exit of the parotid duct and are probably the most common lesions in the mouth. Figure 12-18 depicts Fordyce's spots on the buccal mucosa. Ectopic sebaceous glands can also be found on the shaft of the penis (see Fig. 18-11) and on the labia (see Fig. 19-13).
Acne, oily skin, and hirsutism are all side effects from progestins with increased androgenicity. Older progestins such as norgestrel and levonorgestrel have more an-drogenic effects, whereas agents containing norgestimate or desogestrel are less likely to have such side effects. If patients are complaining of such side effects, switching to a product with a lower risk of androgenic effects is appropriate.
The external female genitalia are shown in Figure 19-1. The vulva consists of the mons veneris, the labia majora, the labia minora, the clitoris, the vestibule and its glands, the urethral meatus, and the vaginal introitus. The mons veneris is a rounded prominence of fat tissue overlying the pubic symphysis. The labia majora are two wide skinfolds that form the lateral boundaries of the vulva. They meet anteriorly at the mons veneris to form the anterior commissure. The labia majora and the mons veneris have hair follicles and sebaceous glands. The labia majora correspond to the scrotum in the man. The labia minora are two narrow, pigmented skinfolds that lie between the labia majora and enclose the vestibule, which is the area lying between the labia minora. Anteriorly, the two labia minora form the prepuce of the clitoris. The clitoris, analogous to the penis, consists of erectile tissue and a rich supply of nerve endings. It has a glans and two corpora cavernosa. The external...
Drugs are eliminated from the body via a number of routes. The two main routes of elimination are in the urine via the kidney and in the faeces via the liver (in bile). Other routes of elimination include the breath, saliva, sebum and milk. The rate at which a volume of fluid can be completely cleared of drug is called the drug clearance rate and is measured in l h. The rate at which a drug is eliminated from the body is called the elimination rate and is measured in mg h. Rapid clearance occurs when the elimination rate is high.
Histologically, it is made up of stratified squamous epithelium with a whitish fibrous capsule containing cellular debris, including keratin and occasionally some lipid material (cholesterin) from cell membrane breakdown (Figure 52-1). The tumor is well circumscribed, and it can be smooth or lob-ulated. To the naked eye it has a white pearly appearance, which led Dandy to describe these tumors as the most beautiful tumors in the body (Figure 52-2A). Epidermoid tumors should be distinguished from dermoid tumors, which also result from congenital ectodermal inclusions. Dermoid inclusion cysts contain other dermal elements such as hair follicles, sebaceous glands, and sweat glands. They are mostly midline and usually accompanied by a dermal sinus. Epidermoid tumors are considered benign tumors. They rarely present with histologically malignant features.
(1) Physiochemical barriers, e.g. intac skin, acidity of stomach, sebum, mucus, cilia, commensal organisms in the body, perspiration, coughing (1) Physiochemical barriers, e.g. intac skin, acidity of stomach, sebum, mucus, cilia, commensal organisms in the body, perspiration, coughing
Acne is a disorder of the pilosebaceous follicles on the face, chest, and back. Follicular obstruction leads to comedones, and inflammation results in papules, pustules, and nodules. The four most important steps in acne pathogenesis are (1) sebum overproduction related to androgenic hormones and genetics, (2) abnormal desquamation of follicular epithelium (keratin plugging), (3) Propionibacterium acnes proliferation, and (4) follicular obstruction, which leads to inflammation and follicular disruption. These steps are stimulated by androgens, and strong genetic factors determine a person's likelihood of developing acne. Although common, acne can cause physical pain, psychosocial suffering, and scarring. Acne may be associated with fever, arthritis, and other systemic symptoms in acne fulminans (Fig. 33-13).
Tinea versicolor presents with hypopigmented, pink brown macules and patches on the trunk with fine scale. Versicolor means varied colors, and this tinea tends to be white, pink, and brown (Fig. 33-51). Tinea versicolor is found on the back, chest, abdomen, and upper arms, often in a capelike distribution. Tinea versicolor is caused by Malassezia furfur (Pityrosporum), a lipophilic yeast that can be normal human cutaneous flora. Tinea versicolor is also called pityriasis versicolor after the causative organism. Pityrosporum is also associated with seborrhea, and thus antidandruff shampoos are effective in treating this tinea. Pityrosporum spp. thrive on sebum and moisture and tend to grow on the skin in areas where sebaceous follicles secrete sebum. Topical and oral treatments are effective, but tinea versicolor tends to recur, especially during the warmer months. The diagnosis can usually be made with the clinical examination, and if there is any doubt, a KOH prep can be examined for...
Papulopustular rosacea presents with acnelike papules and sterile pustules and can occur alone or in combination with the erythema and telangiectasias (Fig. 33-26). Intermittent or chronic facial edema may also occur in all forms. Some patients develop rhinophyma, a coarse hypertrophy of the connective tissue and sebaceous glands of the nose. This can be extremely disfiguring and even cause nasal airway obstruction. Approximately one third of patients with
Intact skin prevents the penetration of most pathogens. Skin consists of two layers, the thinner outer layer, or epidermis, and the thicker dermis. The epidermis is renewed every 2-4 weeks and does not contain blood vessels. The dermis is composed of connective tissue and contains blood vessels, hair follicles, sebaceous glands and sweat glands. The sebaceous glands produce an oily substance termed sebum, made up of lactic acid and fatty acids, maintaining the pH of the skin at around 4. This low pH inhibits bacterial growth. Bacteria which metabolize sebum live on the skin and are responsible for a rare form of acne. Acne treatments such as isotretinoin inhibit sebum formation. Breaks in the skin such as small cuts and insect bites are obvious routes of infection, and diseases such as malaria and Lyme disease are spread via insect bites.
The skin of the scalp contains sweat and sebaceous glands and usually numerous hair follicles. Connective tissue. The tissue between the skin and the aponeurotic layers is composed of dense collagenous connective tissue and contains the arteries, veins and nerves supplying the scalp.
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