Hindawi Publishing Corporation
Journal of Thyroid Research
Volume 2013, Article ID 124538, 5 pages
Thyroid Hormone and Wound Healing
Joshua D. Safer
Section of Endocrinology, Boston University School of Medicine, Room M-1016, 715 Albany Street, Boston, MA 02118, USA
Correspondence should be addressed to Joshua D. Safer; firstname.lastname@example.org
Received 29 January 2013; Accepted 9 February 2013
Academic Editor: Constantinos Pantos
Copyright © 2013 Joshua D. Safer. This is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
to treat cutaneous pathology has never been subject to rigorous investigation. A number of investigators have demonstrated
be of large consequence and merits further study. This is a review of the literature regarding thyroid hormone action on skin along
action on cutaneous cells in vitro and in vivo which may portend the use of thyroid hormone to promote wound healing.
Topical T4has been used to treat xerosis in humans. It is clear that the use of thyroid hormone to treat cutaneous pathology may
Despite early observation of cutaneous pathology associated
with thyroid disease [1, 2], research on the topic remains
sparse. Direct thyroid hormone action has been demon-
strated on cutaneous biology including on the epidermis,
dermis, and hair. In addition, autoimmune diseases with
cutaneous manifestations may be associated with thyroid
dysfunction (which may be autoimmune in etiology itself).
roid hormone might be attributed to the fact that mostcases
of thyroid disease are controlled with existing medication.
However, there is a slowly evolving literature that suggests
that the thyroid hormone pathway is integral to cutaneous
physiology and that manipulation of the thyroid hormone
pathway in skin could be used to treat cutaneous disease.
The skin manifestations of hypothyroidism have been
tion associating hypothyroidism with the thyroid .
tations . Although autoimmune-associated manifestations
may be specific to Graves’ disease, thyrotoxicosis in general
may result in skin sequelae. Starting in the 1950s, there were
attempts to use parenteral and topical tri-iodothyronine (T3)
to treat pretibial myxedema in Graves’ patients [4–7]. In all
cases, lesions improved with topical or intralesional steroids
time, it was noted that topical thyroxine (T4) stimulated hair
growth and pigmentation in cows .
2. Direct Thyroid Hormone Action on
Thyroid hormone action on skin is mediated through the
thyroid hormone receptor (TR). The three most recognized
thyroid hormone binding isoforms of TR have been found
in cutaneous tissues [9–12] although methods used do not
specifically distinguish which of the three isoforms predomi-
hormone, T4. T4is converted to the active thyroid hormone,
third enzyme, D3, converts T4to inactive reverse T3(rT3).
in cutaneous cultures, demonstrating indirectly the presence
of thyroid hormone deiodinases in skin [15–17]. D3 is not
expressed significantly in most peripheral tissues. However,
assays of enzyme activity suggest that D3 is active in goat
epidermis , mouse epidermis , and human skin in
of the enzymes (D1, D2) primarily activate T4to T3. The