Skin as a mirror of endocrine diseases: emerging biomarkers and targeted therapies.

The skin acts as a reflection of systemic endocrine activity, revealing the complex interaction among hormonal, metabolic and immune mechanisms. This narrative review synthesizes current evidence on the molecular and clinical connections between endocrine disorders and dermatologic findings. Endocrine diseases such as diabetes mellitus (DM), thyroid disorders (TD), polycystic ovary syndrome (PCOS), Cushing syndrome (CS) and acromegaly show characteristic skin features that often appear before systemic diagnosis. Dysregulation of insulin-like growth factor-1 (IGF-1) and PI3K/Akt/mTOR pathways, cytokine signaling and epigenetic modulation contribute to these manifestations and represent promising therapeutic targets. Emerging biomarkers including skin derived microRNAs, fibroblast growth factor signaling and advanced glycation end products may support early detection, prognosis and therapeutic monitoring. Integrating dermatologic evaluation into endocrine screening can reduce diagnostic delay, improve patient outcomes and strengthen collaboration between dermatology and endocrinology. Future studies should validate standardized diagnostic algorithms and biomarker-based approaches for personalized care.