What is acanthosis nigricans?
A skin disorder where the skin assumes a thick, coarse, velvety and dark appearance with creases and folds is known as acanthosis nigricans. It is usually seen on the neck, groin, below the breasts, behind knees and armpits and is symmetrical. Acanthosis nigricans is more prevalent in individuals who are obese or diabetic. Acanthosis nigricans incidences in children puts them at a more risk of developing type 2 diabetes.
Causes and risk factors
Acanthosis nigricans is seen in
- African descent- More commonly seen in dark skin
- Insulin resistance: Majority of the individuals with acanthosis nigricans show insulin resistance, ultimately diagnosed as type 2 diabetes.
- In obese individuals
- Issues of adrenal, under-active thyroid or ovarian cyst may predispose the individual to acanthosis nigricans.
- Polycystic Ovarian Syndrome-Acanthosis nigricans is seen in this condition
- It can also occur due to certain medications and supplements like human growth hormone, steroids, protease inhibitors, contraceptive pills and niacin.
- Occasionally it occurs with specific cancers of stomach, liver or colon.
Symptoms and signs
Symptoms of acanthosis nigricans are mainly on the skin and occur very slowly and evident only as changes in the skin.
- The skin will assume a velvety, dark skin with prominent markings and creases visible in the neck, groin and armpits, fingers and toe joints
- Presence of skin tags around the area which has been affected
- Finger-like projections are found on skin and mucosa
- The skin may become itchy too (usually associated with cancers)
- In malignant Acanthosis nigrans, the lesions which are present on mucous membranes, soles and palms are more severe
Acanthosis nigricans is usually diagnosed by the physician by examination of the skin. Sometimes, biopsy might be done to check for any abnormal signs in the skin sample.
If the cause of acanthosis nigricans remain unclear, further tests could include:
- Blood tests
Treatment and prevention
Often treatment is not required as acanthosis nigricans as it normally leads to alterations in the skin’s appearance. Topical retinoids is the first line treatment.Antibiotics are also prescribed. Peels like Trichloroacetic acid (TCA) assist in repairing and rejuvenating the skin. Moisturisers with ammonium lactate are prescribed for improving the appearance of the skin.
The physicians will aim at treating any underlying causes responsible for this condition. Sometimes, losing weight helps in improving acanthosis nigricans.
Surgery may be required if it is triggered by a tumour of cancerous nature. Laser therapy may be helpful in reducing the thickness of the skin.
Your physician may recommend stopping certain medications and supplements if they appear to be the linked with this condition.
You can prevent Acanthosis nigricans by:
- Eating a well balanced diet
- Keeping a regular check on your weight
- Excercising everyday
- Controlling your your blood sugar levels if you are a diabetic
Individuals with acanthosis nigricans are at higher risk of developing type 2 diabetes.
Visit you physician on noticing any changes on your skin. Even a small change in your skin colour or texture should be investigated.
Seek immediate medical attention, if:
- There is a change in your skin colour and texture with rapidly progressing lesions
- If a papillary growth has erupted in your oral cavity and on your lips
- you are diabetic and have noticed a dark patch of skin around your neck, or in the axilla, or under your breast
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- An approach to acanthosis nigricans. Indian Dermatol Online J. 2014 Jul-Sep; 5(3): 239–249. Accessed on 26 Feb. 16. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4144206/