RESUMO
Tyrosinase is a key enzyme in the melanogenesis pathway. Melanin, the product of this process, is the main pigment of the human skin and a major protection factor against harmful ultraviolet radiation (UVR). Increased melanin synthesis due to tyrosinase hyperactivity can cause hyperpigmentation disorders, which in consequence causes freckles, age spots, melasma, or postinflammatory hyperpigmentation. Tyrosinase overproduction and hyperactivity are triggered by the ageing processes and skin inflammation as a result of oxidative stress. Therefore, the control of tyrosinase activity is the main goal of the prevention and treatment of pigmentation disorders. Natural products, especially propolis, according to their phytochemical profile abundant in polyphenols, is a very rich resource of new potential tyrosinase inhibitors. Therefore, this study focused on the assessment of the tyrosinase inhibitory potential of six extracts obtained from the European propolis samples of various origins. The results showed the potent inhibitory activity of all tested propolis extracts towards commercially available mushroom tyrosinase. The four most active propolis extracts showed inhibitory activity in the range of 86.66-93.25%. Apart from the evaluation of the tyrosinase inhibition, the performed research included UHPLC-DAD-MS/MS (ultra high performance liquid chromatography coupled with diode array detection and tandem mass spectrometry) phytochemical profiling as well as antioxidant activity assessment using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) and the 2,2"-azino-bis(3-ethylbenzothiazoline-6-sulfuric acid (ABTS) radical scavenging tests. Moreover, statistical analysis was used to correlate the tyrosinase inhibitory and antioxidant activities of propolis extracts with their phytochemical composition. To summarise, the results of our research showed that tested propolis extracts could be used for skin cosmeceutical and medical applications.
Assuntos
Antioxidantes , Inibidores Enzimáticos , Hiperpigmentação , Monofenol Mono-Oxigenase , Extratos Vegetais , Própole , Humanos , Antioxidantes/química , Antioxidantes/isolamento & purificação , Antioxidantes/farmacologia , Inibidores Enzimáticos/química , Inibidores Enzimáticos/isolamento & purificação , Inibidores Enzimáticos/farmacologia , Hiperpigmentação/enzimologia , Melaninas/metabolismo , Monofenol Mono-Oxigenase/antagonistas & inibidores , Compostos Fitoquímicos , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/farmacologia , Própole/química , Espectrometria de Massas em Tandem , Raios UltravioletaRESUMO
Skin hyperpigmentation is generally characterized by increased synthesis and deposition of melanin in the skin. UP256, containing bakuchiol, is a well-known medication for acne vulgaris. Acne sometimes leaves dark spots on the skin, and we hypothesized that UP256 may be effective against hyperpigmentation-associated diseases. UP256 was treated for anti-melanogenesis and melanocyte dendrite formation in cultured normal human epidermal melanocytes as well as in the reconstituted skin and zebrafish models. Western blot analysis and glutathione S-transferase (GST)-pull down assays were used to evaluate the expression and interaction of enzymes related in melanin synthesis and transportation. The cellular tyrosinase activity and melanin content assay revealed that UP256 decreased melanin synthesis by regulating the expression of proteins related on melanogenesis including tyrosinase, TRP-1 and -2, and SOX9. UP256 also decreased dendrite formation in melanocytes via regulating the Rac/Cdc42/α-PAK signaling proteins, without cytotoxic effects. UP256 also inhibited ciliogenesis-dependent melanogenesis in normal human epidermal melanocytes. Furthermore, UP256 suppressed melanin contents in the zebrafish and the 3D human skin tissue model. All things taken together, UP256 inhibits melanin synthesis, dendrite formation, and primary cilium formation leading to the inhibition of melanogenesis.
Assuntos
Cílios/enzimologia , Regulação Enzimológica da Expressão Gênica , Hiperpigmentação/enzimologia , Melanócitos/enzimologia , Monofenol Mono-Oxigenase/biossíntese , Transdução de Sinais , Regulação para Cima , Proteínas de Peixe-Zebra/biossíntese , Peixe-Zebra/metabolismo , Animais , Linhagem Celular , Cílios/patologia , Dendritos/enzimologia , Dendritos/patologia , Humanos , Hiperpigmentação/tratamento farmacológico , Hiperpigmentação/patologia , Fatores de Transcrição SOX9/metabolismo , Tripsina/metabolismoRESUMO
Epidermal keratinocytes are considered as the most important neighboring cells that modify melanogenesis. Our previous study used microarray to show that guanine deaminase (GDA) gene expression is highly increased in melasma lesions. Hence, we investigated the role of GDA in skin pigmentation. We examined GDA expression in post-inflammatory hyperpigmentation (PIH) lesions, diagnosed as Riehl's melanosis. We further investigated the possible role of keratinocyte-derived GDA in melanogenesis by quantitative PCR, immunofluorescence staining, small interfering RNA-based GDA knockdown, and adenovirus-mediated GDA overexpression. We found higher GDA positivity in the hyperpigmentary lesional epidermis than in the perilesional epidermis. Both UVB irradiation and stem cell factor (SCF) plus endothelin-1 (ET-1) were used, which are well-known melanogenic stimuli upregulating GDA expression in both keratinocyte culture alone and keratinocyte and melanocyte coculture. GDA knockdown downregulated melanin content, while GDA overexpression promoted melanogenesis in the coculture. When melanocytes were treated with UVB-exposed keratinocyte-conditioned media, the melanin content was increased. Also, GDA knockdown lowered SCF and ET-1 expression levels in keratinocytes. GDA in epidermal keratinocytes may promote melanogenesis by upregulating SCF and ET-1, suggesting its role in skin hyperpigmentary disorders.
Assuntos
Guanina Desaminase/metabolismo , Hiperpigmentação/patologia , Queratinócitos/metabolismo , Melaninas/metabolismo , Pigmentação da Pele , Adulto , Idoso , Estudos de Casos e Controles , Células Cultivadas , Técnicas de Cocultura , Meios de Cultivo Condicionados , Endotelina-1/metabolismo , Feminino , Guanina Desaminase/genética , Humanos , Hiperpigmentação/enzimologia , Melanócitos/enzimologia , Melanócitos/patologia , Pessoa de Meia-Idade , Fator de Células-Tronco/metabolismoAssuntos
Mutação da Fase de Leitura , Glucosiltransferases/genética , Hiperpigmentação/genética , Dermatopatias Genéticas/genética , Dermatopatias Papuloescamosas/genética , Pigmentação da Pele/genética , Biópsia , Análise Mutacional de DNA , Feminino , Predisposição Genética para Doença , Humanos , Hiperpigmentação/diagnóstico , Hiperpigmentação/enzimologia , Japão , Pessoa de Meia-Idade , Fenótipo , Dermatopatias Genéticas/diagnóstico , Dermatopatias Genéticas/enzimologia , Dermatopatias Papuloescamosas/diagnóstico , Dermatopatias Papuloescamosas/enzimologiaRESUMO
In therapeutic interventions associated with melanin hyperpigmentation, tyrosinase is regarded as a target enzyme as it catalyzes the rate-limiting steps in mammalian melanogenesis. Since many known agents have been proven to be toxic, there has been increasing impetus to identify alternative tyrosinase inhibitors, especially from natural sources. In this study, we investigated 900 extracts from Greek plants for potential tyrosinase inhibitive properties. Among the five most potent extracts, the methanol extract of Morus alba wood (MAM) demonstrated a significant reduction in intracellular tyrosinase and melanin content in B16F10 melanoma cells. Bioassay-guided isolation led to the acquisition of twelve compounds: oxyresveratrol (1), kuwanon C (2), mulberroside A (3), resorcinol (4), dihydrooxyresveratol (5), trans-dihydromorin (6), 2,4,3'-trihydroxydihydrostilbene (7), kuwanon H (8), 2,4-dihydroxybenzaldehyde (9), morusin (10), moracin M (11) and kuwanon G (12). Among these, 2,4,3'-trihydroxydihydrostilbene (7) is isolated for the first time from Morus alba and constitutes a novel potent tyrosinase inhibitor (IC50 0.8 ± 0.15). We report here for the first time dihydrooxyresveratrol (5) as a potent natural tyrosinase inhibitor (IC50 0.3 ± 0.05). Computational docking analysis indicated the binding modes of six tyrosinase inhibitors with the aminoacids of the active centre of tyrosinase. Finally, we found both MAM extract and compounds 1, 6 and 7 to significantly suppress in vivo melanogenesis during zebrafish embryogenesis.
Assuntos
Inibidores Enzimáticos/isolamento & purificação , Hiperpigmentação/enzimologia , Metanol/isolamento & purificação , Monofenol Mono-Oxigenase/antagonistas & inibidores , Morus/química , Animais , Linhagem Celular Tumoral , Inibidores Enzimáticos/farmacologia , Hiperpigmentação/tratamento farmacológico , Melaninas/biossíntese , Melanoma/tratamento farmacológico , Melanoma/enzimologia , Metanol/química , Metanol/farmacologia , Camundongos , Simulação de Acoplamento Molecular , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/farmacologiaRESUMO
Dowling-Degos disease (DDD) is an autosomal-dominant disorder of skin pigmentation associated with mutations in keratin 5 (KRT5), protein O-fucosyltransferase 1 (POFUT1), or protein O-glucosyltransferase 1 (POGLUT1). Here, we have identified 6 heterozygous truncating mutations in PSENEN, encoding presenilin enhancer protein 2, in 6 unrelated patients and families with DDD in whom mutations in KRT5, POFUT1, and POGLUT1 have been excluded. Further examination revealed that the histopathologic feature of follicular hyperkeratosis distinguished these 6 patients from previously studied individuals with DDD. Knockdown of psenen in zebrafish larvae resulted in a phenotype with scattered pigmentation that mimicked human DDD. In the developing zebrafish larvae, in vivo monitoring of pigment cells suggested that disturbances in melanocyte migration and differentiation underlie the DDD pathogenesis associated with PSENEN. Six of the PSENEN mutation carriers presented with comorbid acne inversa (AI), an inflammatory hair follicle disorder, and had a history of nicotine abuse and/or obesity, which are known trigger factors for AI. Previously, PSENEN mutations were identified in familial AI, and comanifestation of DDD and AI has been reported for decades. The present work suggests that PSENEN mutations can indeed cause a comanifestation of DDD and AI that is likely triggered by predisposing factors for AI. Thus, the present report describes a DDD subphenotype in PSENEN mutation carriers that is associated with increased susceptibility to AI.
Assuntos
Secretases da Proteína Precursora do Amiloide/genética , Hidradenite Supurativa/genética , Hiperpigmentação/genética , Proteínas de Membrana/genética , Dermatopatias Genéticas/genética , Dermatopatias Papuloescamosas/genética , Animais , Códon sem Sentido , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Hidradenite Supurativa/enzimologia , Hiperpigmentação/enzimologia , Masculino , Dermatopatias Genéticas/enzimologia , Dermatopatias Papuloescamosas/enzimologia , Peixe-ZebraRESUMO
OBJECTIVES: Pharmacological studies of Aster spathulifolius Maxim(AS) have demonstrated its anti-allergy, anti-viral and anti-obesity effects, however, its anti-melanogenic effects is still unclear. In this study, the effects of AS extract (ASE) on the inhibition of melanin synthesis were investigated in vitro and in vivo. METHODS: To perform this study, the contents of melanin and tyrosinase activity were analysed in B16F10 melanoma cells. Western blotting was carried out to determine the underlyling mechanism. Additionally, we investigated the effect of this extract on hyperpigmentation in C57bL/6J mice induced by 3, 6 and 9 weeks of UVB irradiation. KEY FINDINGS: AS extract led to reduced melanin synthesis through the regulation of MITF and its downstream signals. Furthermore, ASE increased the phosphorylation of MAPK/ERK and Akt/GSK3ß signalling pathway components. In vivo study, hypopigmentation effects were also observed. The melanocyte activity and the distribution of melanin granules were decreased in UVB-irradiated mice treated with ASE. CONCLUSIONS: These results suggest that the ASE may be promising as an active anti-melanogenic component, and further investigations should be performed regarding its potential as a whitening agent in the field of cosmetics.
Assuntos
Aster/química , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Glicogênio Sintase Quinase 3 beta/metabolismo , Hiperpigmentação/prevenção & controle , Melaninas/metabolismo , Melanoma Experimental/tratamento farmacológico , Extratos Vegetais/farmacologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Preparações Clareadoras de Pele/farmacologia , Neoplasias Cutâneas/tratamento farmacológico , Pele/efeitos dos fármacos , Raios Ultravioleta , Animais , Linhagem Celular Tumoral , Cromatografia Líquida de Alta Pressão , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , MAP Quinases Reguladas por Sinal Extracelular/antagonistas & inibidores , Glicogênio Sintase Quinase 3 beta/antagonistas & inibidores , Hiperpigmentação/enzimologia , Melanócitos/efeitos dos fármacos , Melanócitos/enzimologia , Melanoma Experimental/enzimologia , Melanoma Experimental/patologia , Camundongos Endogâmicos C57BL , Fator de Transcrição Associado à Microftalmia/metabolismo , Monofenol Mono-Oxigenase/metabolismo , Fosforilação , Fitoterapia , Extratos Vegetais/isolamento & purificação , Plantas Medicinais , Inibidores de Proteínas Quinases/farmacologia , Proteínas Proto-Oncogênicas c-akt/antagonistas & inibidores , Transdução de Sinais/efeitos dos fármacos , Pele/enzimologia , Preparações Clareadoras de Pele/isolamento & purificação , Neoplasias Cutâneas/enzimologia , Neoplasias Cutâneas/patologia , Pigmentação da Pele/efeitos dos fármacos , Espectrometria de Massas por Ionização por Electrospray , Fatores de TempoRESUMO
Piper amides have a characteristic, unsaturated amide group and exhibit diverse biological activities, including proliferation and differentiation of melanocytes, although the molecular mechanisms underlying its antimelanogenesis effect remain unknown. We screened a selected chemical library of newly synthesized Piper amide derivatives and identified (E)-3-(4-(tert-butyl)phenyl)-N-(2,3-dihydrobenzo[b][1,4]dioxin-6-yl)acrylamide (NED-180) as one of the most potent compounds in suppressing melanogenesis. In murine melan-a melanocytes, NED-180 downregulated the expression of melanogenic regulatory proteins including tyrosinase, Tyrp1, Dct, and MITF. PI3K/Akt-dependent phosphorylation of GSK3ß by NED-180 decreases MITF phosphorylation and inhibits melanogenesis without any effects on cytotoxicity and proliferation. Furthermore, topical application of NED-180 significantly ameliorated UVB-induced skin hyperpigmentation in guinea pigs. Interestingly, data obtained using calcium imaging techniques suggested that NED-180 reduced the TPA-induced activation of TRPM1 (melastatin), which could explain the NED-180-induced inhibition of melanogenesis. All things taken together, NED-180 triggers activation of multiple pathways, such as PI3K and ERK, and inhibits TRPM1/TRPV1, leading to inhibition of melanogenesis.
Assuntos
Acrilamidas/uso terapêutico , Amidas/uso terapêutico , Cálcio/metabolismo , Dioxanos/uso terapêutico , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Hiperpigmentação/tratamento farmacológico , Sistema de Sinalização das MAP Quinases , Fosfatidilinositol 3-Quinases/metabolismo , Piper/química , Canais de Cátion TRPM/metabolismo , Acrilamidas/farmacologia , Amidas/farmacologia , Animais , Dioxanos/farmacologia , Quinase 3 da Glicogênio Sintase/metabolismo , Glicogênio Sintase Quinase 3 beta , Cobaias , Células HEK293 , Humanos , Hiperpigmentação/enzimologia , Oxirredutases Intramoleculares/metabolismo , Melaninas/metabolismo , Camundongos , Modelos Biológicos , Monofenol Mono-Oxigenase/metabolismo , Fosforilação , Proteínas Proto-Oncogênicas c-akt/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Pele/efeitos dos fármacosRESUMO
Due to its multiple biological activities, 5,7-dihydroxyflavone (chrysin) in propolis has gained attention as potentially useful therapeutics for various diseases. However, the efficacy of chrysin for the use of dermatological health has not been fully explored. To clarify the action mechanism of the skin protecting property of chrysin, we firstly investigated the molecular docking property of chrysin on the mammalian adenylyl cyclase, which is the key enzyme of cAMP-induced melanogenesis. We also examined the involvement of chrysin in alpha-MSH and forskolin-induced cAMP signaling within a cell based assay. In addition, we inquired into the inhibitory effect of chrysin on melanogenesis and found that the pretreatment with chrysin inhibited the forskolin-induced melanin contents significantly without annihilating the cell viability. These results strongly suggest that chrysin directly inhibits the activity of adenylyl cyclase, downregulates forskolin-induced cAMP-production pathway, consequently inhibiting melanogenesis. Thus, chrysin may also be used as an effective inhibitor of hyperpigmentation.
Assuntos
Inibidores de Adenilil Ciclases , Flavonoides/farmacologia , Hiperpigmentação/enzimologia , Melaninas/antagonistas & inibidores , Melaninas/biossíntese , Adenilil Ciclases/biossíntese , Adenilil Ciclases/química , Animais , Sobrevivência Celular/efeitos dos fármacos , Colforsina/química , Colforsina/farmacologia , Flavonoides/química , Melanoma Experimental/enzimologia , Camundongos , Estrutura Secundária de ProteínaRESUMO
BACKGROUND: Disorders, such as age spots, melasma and hyperpigmentation at sites of actinic damage, emanate from the augmentation of an increased amount of epidermal melanin. OBJECTIVES: The ineptness of current therapies in treating these conditions, as well as high cytotoxicity, mutagenicity, poor skin penetration and low stability of skin-depigmenting formulations led us to investigate new compounds that meet the medical requirements for depigmentation agents. We have shown previously that the tyrosinase inhibitor deoxyArbutin (dA) is a more effective and less toxic skin lightener than hydroquinone (HQ). METHODS: The efficacy and reversibility of dA and its derivatives on inhibiting tyrosine hydroxylase and DOPAoxidase was assessed using standard assays. RESULTS: dA and its second-generation derivatives inhibit tyrosine hydroxylase and DOPAoxidase activities of tyrosinase dose dependently thereby inhibiting melanin synthesis in intact melanocytes, when used at concentrations that retain 95% cell viability in culture. This depigmenting effect was completely reversible when the compounds were removed. Tyrosinase inhibition was also observed in vitro when tested using human and purified mushroom tyrosinase, establishing that they are direct enzyme inhibitors. Lineweaver-Burk reciprocal plot analysis using mushroom tyrosinase illustrated that dA and its derivatives are more robust competitive inhibitors than HQ, when tyrosine is used as substrate. CONCLUSIONS: Thus, dA and its second-generation derivatives, which inhibit melanogenesis at safe concentrations by specifically acting on the tyrosinase enzyme at a post-translational level, are promising agents to ameliorate hyperpigmented lesions or lighten skin.
Assuntos
Arbutina/análogos & derivados , Inibidores Enzimáticos/farmacologia , Hiperpigmentação/tratamento farmacológico , Melanócitos/efeitos dos fármacos , Monofenol Mono-Oxigenase/antagonistas & inibidores , Tirosina 3-Mono-Oxigenase/metabolismo , Arbutina/farmacologia , Dopaminérgicos/análise , Humanos , Hiperpigmentação/enzimologia , Melanócitos/enzimologiaRESUMO
Several tyrosinase inhibitors have been developed and utilized to ameliorate various cutaneous hyperpigmentary disorders and complexion discolorations. Deoxyarbutin (dA) (i.e., 4-[(tetrahydro-2H-pyran-2-yl)oxy]phenol), designed using quantitative structure-activity relationships (QSAR), demonstrates effective inhibition of mushroom tyrosinase and skin-lightening capability (1). However, its comparative safety, effectiveness, and reversibility to other known tyrosinase inhibitors in human melanocytes had not been determined. The effect of dA was assessed in cultured human skin cells, on xenographs, and with a clinical trial. Using cultured human melanocytes, the maximum concentration of dA that allowed 95% viability was fourfold greater than for hydroquinone (HQ), indicating that dA is less cytotoxic/cytostatic than HQ. The viability of cultured human keratinocytes and fibroblasts was also less compromised by increasing concentrations of dA as opposed to HQ. At the maximum concentration allowing normal cellular viability, dA effectively inhibited tyrosinase activity and melanin content in human melanocytes, whereas HQ was marginally inhibitory. Upon removal of dA, tyrosinase activity and melanin content was normalized within five days. Topical application of dA on human xenografts resulted in a gradual and visually apparent skin lightening effect during an eight-week period. In a clinical trial, dA facilitated fading of pre-tanned skin to a statistically significant greater extent than either HQ or no treatment. These results demonstrate that dA is a potentially safe, effective, and reversible tyrosinase inhibitor.
Assuntos
Arbutina/análogos & derivados , Hiperpigmentação/tratamento farmacológico , Monofenol Mono-Oxigenase/antagonistas & inibidores , Pigmentação da Pele/efeitos dos fármacos , Administração Tópica , Adolescente , Adulto , Animais , Arbutina/farmacologia , Biópsia , Sobrevivência Celular/efeitos dos fármacos , Feminino , Humanos , Hidroquinonas/farmacologia , Hiperpigmentação/enzimologia , Masculino , Melanócitos/efeitos dos fármacos , Melanócitos/metabolismo , Camundongos , Camundongos SCID , Pessoa de Meia-Idade , Monofenol Mono-Oxigenase/metabolismo , Pele/efeitos dos fármacos , Pele/enzimologia , Organismos Livres de Patógenos Específicos , Transplante HeterólogoRESUMO
Chronic venous insufficiency (CVI) progresses through a series of clinical stages, from healthy skin to poorly healing leg ulcers. The aim of this study was to analyse the distribution pattern and activity level of urokinase-type (uPA) and tissue-type plasminogen activators (tPA) in normal skin and in tissue biopsies of progressing stages of CVI, prior to and including venous ulceration. Biopsies 6 mm thick were taken from 14 healthy volunteers and 37 patients with 5 different stages of CVI: telangiectases; stasis dermatitis; hyperpigmentation; lipodermatosclerosis; and leg ulcer. Changes in the enzymatic activity and spatial localization of uPA and tPA during the progression of CVI were examined using in situ histological zymography. Normal skin and skin with telangiectases showed a punctate PA activity, consisting of both uPA and tPA activity. As CVI progressed, an increase in the distribution of uPA and a decrease in tPA activity was observed. The spatial localization of uPA was widespread within the dermis of biopsies from stasis dermatitis and lipodermatosclerosis and was associated in particular with the dermoepidermal junction. Hyperpigmented skin revealed a pattern of PA expression similar to that of healthy skin. However, leg ulcer specimens exhibited peak levels of uPA with little tPA. Furthermore, a plasminogen-independent protease activity that was not present in any of the earlier stages of CVI appeared. Our results indicate that there are profound changes in PA activity during the progression of CVI and that these changes begin early in CVI, for example, in stasis dermatitis. We hypothesize that the balance or imbalance of the PA activity in the later stages of CVI is an important pathogenic factor for the development of venous leg ulcer.
Assuntos
Ativador de Plasminogênio Tecidual/metabolismo , Ativador de Plasminogênio Tipo Uroquinase/metabolismo , Insuficiência Venosa/enzimologia , Adulto , Idoso , Doença Crônica , Dermatite/enzimologia , Dermatite/etiologia , Progressão da Doença , Feminino , Humanos , Hiperpigmentação/enzimologia , Hiperpigmentação/etiologia , Masculino , Pessoa de Meia-Idade , Esclerodermia Localizada/enzimologia , Esclerodermia Localizada/etiologia , Pele/enzimologia , Pele/patologia , Telangiectasia/enzimologia , Telangiectasia/etiologia , Úlcera Varicosa/enzimologia , Úlcera Varicosa/etiologia , Insuficiência Venosa/complicações , Insuficiência Venosa/patologiaRESUMO
Klinefelter's syndrome is the most frequent major abnormality of sexual differentiation in men with two or more X-chromosomes, and affects one in 500 males. The syndrome is characterized by eunuchoid body proportions, scanty facial and body hair, gynaecomastia, and small firm testes. Leg ulcers, especially in combination with hyperpigmentation, have been reported in association with Klinefelter's syndrome. Thromboembolic processes are also frequently observed. The leg ulcers in patients with Klinefelter's syndrome are usually attributed to venous insufficiency. We describe two patients with Klinefelter's syndrome associated with recurrent ulcers and hyperpigmentation on both legs, in whom no venous or other underlying cause could be found. The patients were not taking any drugs, in particular no supplemental androgen therapy. Both had normal plasma testosterone values. We detected increased activity of plasminogen activator inhibitor 1 (PAI-1), with only a partial decrease upon venous occlusion. A possible role for this inhibitor of fibrinolysis in the pathogenesis of ulceration is discussed.