Plasma Levels of Cortisol, Cortisone Lower in Patients With Prurigo Nodularis

Greater pruritus severity is associated with lower plasma concentrations of cortisol and cortisone in patients with prurigo nodularis (PN), suggests a pilot study published in Frontiers in Physiology.

“It has been suggested that cortisol levels are abnormal in chronic urticaria and atopic dermatitis, but other steroids, such as dehydroepiandrosterone (DHEA) and testosterone, are still unknown, and whether these hormones affect the maintenance of skin homeostasis or the pathogenesis of skin diseases is not fully understood,” explained a research team from China in the study background. “Limited data are available on steroid levels in PN-related research, and no study has examined the association between pruritus severity and steroid levels in PN patients.”

The pilot study aimed to fill the gap by investigating levels of cortisol, cortisone, testosterone, progesterone, and DHEA, and their ratios, in 36 patients with PN and 36 matched healthy control subjects.

Patients with PN had lower levels of plasma cortisol and cortisone, which negatively correlated with PN symptoms, according to the study. Meanwhile, levels of cortisone and testosterone to cortisol were higher, and they positively correlated with pruritus severity.

Researchers found no notable differences in plasma levels of DHEA and testosterone between patients and control subjects. Furthermore, there was no correlation between plasma concentrations of DHEA and testosterone and pruritus severity.

“To the best of our knowledge, this was the first attempt to screen sensitive endocrine biomarkers for objectively assessing the pruritus severity of PN,” researchers wrote. “This was also the first investigation to verify the influence of PN on the two neuroendocrine systems, including the hypothalamic-pituitary-adrenal and hypothalamo-pituitary-gonadal axes, as well as on the interactions between the two systems.”

Reference:
Chu L, Shu X, Wu Y, Yang H, Lu Q, Deng H. Abnormal plasma levels of steroids and their ratios in patients with prurigo nodularis: a pilot study. Front Physiol. Published online June 28, 2022. doi:10.3389/fphys.2022.835269