What is Acanthosis Nigricans?

It is a skin disorder characterized by thickening, pigmentation and a fine or rough velvety appearance, particularly over body folds like neck, axilla and groin. The importance of acanthosis nigricans lies in the fact that it can be caused by a variety of diseases, from obesity to cancer.

People with acanthosis nigricans are known for their resistance to insulin in diabetes.

According to the causes, acanthosis nigricans is divided into two major types:

A. BENIGN ACANTHOSIS NIGRICANS

Hereditary benign acanthosis nigricans: This runs in families, but does not usually show any evidence of endocrinological disturbances or internal malignancy.

Internal malignancies (cancers), especially the adenocarcinomas affecting the stomach, lungs etc can cause acanthosis nigricans. Sometimes lymphoma may be the culprit.

Hence it is essential to find out the cause of acanthosis nigricans. Here are a few pointers that may help in differentiating benign from malignant variety of acanthosis nigricans:

How to Differentiate Between the Innocent Benign and the Dangerous Malignant Varieties?

Click Her e for an image of Acanthosis nigricans.

Onset : Benign - Birth, childhood or puberty. Malignant - Adulthood, old age

Distribution:

Extent of involvement: Benign - Less. Malignant - Widespread

Distal extremities: Benign - Spared. Malignant - Affected

Mucous membrane involvement: Benign - Rare . Malignant - Common-up to 50%

Hair, nail, palms & soles: Benign - Rare, Malignant - Common

Pigmentation: Benign - Less, limited to thickened areas. Malignant - More, extend beyond thickened areas.

Skin Thickening: Benign - Mild to moderate. Malignant - Marked

Skin Irritation: Benign - Less or nil. Malignant - More

When to Consult Dermatologist?

When the pigmentation is severe and the signs of malignancy is present as above.

Salient Points indicating presence of associated internal cancer are:

Late onset

Do's:

Differentiate between benign and malignant with the help of a dermatologist

Scrub too much, as frequent rubbing will only increase skin thickening and pigmentation

1. Correction of underlying cause

Removal of tumor

beneficial

3. Cyproheptadine has been found useful in some cases

4. Management of Skin Lesions:

Topical Retin A

Curth HO (Archives of Dermatology, Vol 102, 1970) reports a remarkable case of acanthosis nigricans persisting for years even after excising a leiomyoma of stomach,squamous cell carcinoma of bladder and nephrectomy of one kidney for transitional cell carcinoma in a 84 year old man. Then one lesion of adenocarcinoma was found in his colon and removed. Surprise! His long standing acanthosis nigricans disappeared within a few days without any treatment! Moral: To achieve cure you must excise the responsible hormone secreting tumor, not just any tumor!

Disclaimer

Information provided in this article is strictly for educational purposes and is not meant to substitute for the advice provided by your own dermatologist or other medical professionals. You should not use the information contained herein for diagnosing or treating a health problem or disease, or prescribing any medication. Many skin diseases have similar morphology and may resemble one another, though their treatment protocol varies. Hence, self diagnosis and treatment are not advised. In case of doubt always be on the safer side and consult your dermatologist or physician.

Dr.Hanish Babu, MD is a Dermato-Venereologist, author, stress management trainer and a netpreneur. He has recently released a stress management package "10 Days to Stress Free Life".

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