Acanthosis Nigricans | Understanding the Skin Condition

Exploring the Causes, Risks, and Treatments of Acanthosis Nigricans

Dark, thickened skin around the neck or armpits may indicate Acanthosis Nigricans, a condition often associated with insulin resistance and other health concerns.

InBrief

What is Acanthosis Nigricans?

Acanthosis nigricans is a skin disorder characterized by hyperpigmented skin plaques, often in a symmetrical distribution on the neck and axilla. The skin may appear dirty, rough, and thickened. The condition can also present on mucosa. It is typically asymptomatic unless it becomes inflamed secondary to bacterial or yeast infection. Although the pathogenesis of acanthosis nigricans is unknown, hyperinsulinemia may contribute to its development.

Causes and Risk Factors

There is no established cause of acanthosis nigricans; however, it is associated with certain conditions, particularly those involving insulin resistance (eg, obesity, diabetes mellitus, polycystic ovarian syndrome, metabolic syndrome). Other associated conditions are malignancy, particularly gastric adenocarcinomas. If associated with malignancy, acanthosis nigricans may appear with rapid onset at atypical sites such as the palms and soles, and patients may lose weight. It is less commonly associated with medications that are associated with hyperinsulinemia, such as systemic glucocorticoids and oral contraceptives.

Treatment Options

Acanthosis nigricans may resolve with treatment of the underlying associated condition, and weight loss is recommended if it is associated with obesity. Because the condition is benign, treatment specifically for acanthosis nigricans is considered cosmetic. Use of topical retinoids and vitamin D analogs have been reported in a limited number of patients.

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Sources:

Schwartz R. Acanthosis nigricans. J Am Acad Dermatol. 1994;31:1-19.
Patel N, Roach C, Alinia H, Huang W, Feldman S. Current treatment options for acanthosis nigricans. Clin Cosmet Investig Dermatol. 2018;11:407-413.