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Department of Pathology (A.S.), University of Tennessee, Memphis, Tennessee 38163; and Department of Medicine (J.W.), Southern Illinois University, Springfield, Illinois
The classical observations of the skin as a target for melanotropins
have been complemented by the discovery of their actual production at
the local level. In fact, all of the elements controlling the activity
of the hypothalamus-pituitary-adrenal axis are expressed in the skin
including CRH, urocortin, and POMC, with its products ACTH, 
-MSH,
and ß-endorphin. Demonstration of the corresponding receptors in the
same cells suggests para- or autocrine mechanisms of action. These
findings, together with the demonstration of cutaneous production of
numerous other hormones including vitamin D3, PTH-related
protein (PTHrP), catecholamines, and acetylcholine that share
regulation by environmental stressors such as UV light, underlie a role
for these agents in the skin response to stress. The endocrine
mediators with their receptors are organized into dermal and epidermal
units that allow precise control of their activity in a
field-restricted manner. The skin neuroendocrine system communicates
with itself and with the systemic level through humoral and neural
pathways to induce vascular, immune, or pigmentary changes, to directly
buffer noxious agents or neutralize the elicited local reactions.
Therefore, we suggest that the skin neuroendocrine system acts by
preserving and maintaining the skin structural and functional integrity
and, by inference, systemic homeostasis.
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