Formation and concentration of dehydroepiandrosterone sulphate in the abdominal skin of healthy individuals and patients with endocrine disease.

In vitro incubation studies demonstrated that abdominal skin slices from healthy females and males converted 1.05-2.73% (mean 1.75%) and 0.64-2.06% (mean 1.32%), respectively of [4-14C]dehydroepiandrosterone (DHA) to [4-14C]dehydroepiandrosterone sulphate (DHA-S) and that the delta 5-3 beta-hydroxysteroid sulphokinase(delta 5-3 beta-HSS) activities were almost identical in female and male abdominal skin. DHA-S formation in the skin of females with hirsutism of adrenocortical, ovarial or idiopathic origin was shown not to differ from that in healthy females; the hyperandrogenism in the skin of hirsute females is thus not a consequence of a delta 5-3 beta-HSS deficiency. In vitro synthesis of DHA-S in the abdominal skin of patients with complete testicular feminization or 46XY pure gonad dysgenesis and anorchia was similar to that in healthy subjects. Addition of synthetic human alpha 1-39-ACTH and natural (porcine) ACTH to in vitro incubates of abdominal skin slices from healthy females or females with various types of hirsutism increased the formation of DHA-S, revealing thereby a further extra-adrenal effect of ACTH. In the abdominal skin of healthy females and males the DHA concentration did not differ, but the concentration of DHA-S was much higher in males. The DHA-S concentration in the abdominal skin of idiopathic hirsutism patients was pathologically high in spite of the blood DHA-S level being normal. The considerable accumulation of DHA-S in the abdominal skin of healthy males and hirsute females cannot be explained by the normal delta 5-3 beta-HSS activity; thus, it is assumed that either the DHA-S elimination mechanism may be changed in the abdominal skin slices, or the DHA-S binding proteins might be multiplied.