ACANTHOSIS NIGRICANS- CAUSES, DIAGNOSIS AND TREATMENT
Medically Reviewed by Dr. Sony Sherpa (MBBS) - July 25, 2023
What Causes Acanthosis Nigricans?
Symptoms Of Acanthosis Nigricans
How Is Acanthosis Nigricans Diagnosed?
Acanthosis nigricans result in patches of dark, thick, velvety skin in the folds and crevices of the body. Usually, the groin, neck, and armpits are affected.
Acanthosis nigricans mostly affect obese people. Rarely, the skin problem may be a symptom of cancer in an internal organ, like the liver or stomach. However, the normal color and texture of the skin could be restored by treating the underlying cause.
What Causes Acanthosis Nigricans?
Acanthosis nigricans may be associated with:
Insulin resistance
The majority of people with acanthosis nigricans have insulin resistance. The pancreas produces the hormone insulin, which the body uses to digest sugar. When a lot of sugar enters the bloodstream, the pancreas works on overdrive and pumps out more insulin to get the excess glucose inside the cells.
Over time, the cells will stop responding to the action of insulin, leading to insulin resistance. Type 2 diabetes is brought on by insulin resistance. In addition, insulin resistance may contribute to the development of acanthosis nigricans and is associated with polycystic ovarian syndrome.
Cancer
Acanthosis nigricans can also occur as a side effect of several cancers. These include liver, stomach, colon cancers, and lymphoma.
Drugs and supplements
Acanthosis nigricans may be brought on by a few medications and dietary supplements. These include:
- Nicotinic acid
- Thyroid medications
- Diethylstilbestrol
- Injected supplementary insulin
- Human growth hormones
- Birth control pills
- Systemic glucocorticoids
- Some bodybuilding supplements
- Estrogen
- Protease inhibitors
Who Is At Risk?
Both males and females can acquire acanthosis nigricans. It is most prevalent in:
- People who are overweight
- Those who are from or whose ancestors are from Africa, the Caribbean, and South or Central America
- Those who are prediabetic or have diabetes
- Native Americans
- People who have acanthosis nigricans in their family
- Acanthosis nigricans in children increases the risk of type 2 diabetes in adulthood.
What Are The Symptoms Of Acanthosis Nigricans?
Hyperkeratosis and hyperpigmentation are the primary signs and symptoms of acanthosis nigricans. A person can notice these changes in their skin's tone and texture.
The signs of acanthosis nigricans usually come on gradually. However, rapidly escalating symptoms could be a sign of cancer, and you should seek help from a dermatologist.
The following are the symptoms of this skin condition:
- Brown or black skin patches
- Skin with a velvety feel
- Itchiness
- Skin tags
- Areas of skin that smell bad
These dark patches could show up on folds of skin and other places, such as the:
- Back of your neck
- Armpits
- Groin, particularly in creases and skin folds
- Face
- Elbows
- Knees
- knuckles
- Underneath the breast
- Lips
- Palms
- Navel
- Soles of the feet
Some people have these skin changes on just one side of their bodies. This condition is referred to as unilateral acanthosis nigricans.
Rarely, usually in situations involving cancer, acanthosis nigricans skin abnormalities may manifest on the:
- Areolae, the area around the nipples
- Mucous membranes of the throat, nose, and mouth
- The eyelids and a portion of the eye
How Is Acanthosis Nigricans Diagnosed?
Acanthosis nigricans is simple to diagnose at a glance. However, to determine the cause, your doctor may want to test for diabetes or insulin resistance.
These examinations could involve fasting insulin tests or blood glucose assays. To determine if medications contribute to the condition, your doctor may also review them.
It is crucial to let your doctor know about any vitamins, bodybuilding supplements, or nutritional supplements you are taking in addition to any prescription drugs.
Rarely, your doctor may order additional tests, such as a tiny skin biopsy, to rule out any other potential causes.
Treatment Of Acanthosis Nigricans
Acanthosis nigricans is not a disease. It is a sign that you might need to see a doctor because it is a symptom of another ailment, like diabetes. It also does not have a specific treatment.
Your healthcare physician can advise using skin creams, medicated soaps, drugs, or laser therapy to help with the pain and odor.
The primary goal of treatment is to treat the underlying problem causing it. For example, a medical expert might suggest that you keep your weight at a healthy level if you are overweight. Additionally, they might recommend drugs to help you manage your blood sugar.
Your doctor might advise stopping the drug or supplement if it is the cause of the condition or offer an alternative. When you identify the source and start treatment, the discolored skin patches will typically go away.
A healthy diet, regular exercise, and weight loss frequently lower insulin levels, which improves skin texture. The patches can entirely disappear. Antibiotics are another form of treatment for odor or pain.
Cosmetic procedures
You might wish to try certain cosmetic treatments if you are bothered by how your damaged skin looks. Treatments include:
- Alpha hydroxy acids, salicylic acid, and Retin-A, which help lighten the skin
- Laser therapy
- Oral acne medications
Acanthosis nigricans cannot be cured by these treatments, but they can improve the skin’s appearance. Avoid using skin care products to fix dark spots without seeking advice from a healthcare professional. These products could be ineffective and irritate your skin, worsening the situation.
When To See A Doctor?
People should schedule a visit with their doctor if they see their skin becoming thicker or darker or experience other skin issues and discomfort. The alterations are frequently benign. However, they might be a sign of another disease that needs attention.
The Outlook
If you have a slowly developing, benign form of acanthosis nigricans, it is likely that you may not experience complications (or few, even if they do occur). The outlook will be good, and treatments will generally resolve the patch.
The development of additional, riskier consequences from an underlying illness like diabetes is still possible.
The prognosis is typically less promising for malignancies that are rapidly growing. The cancer is probably already in an advanced stage when acanthosis nigricans manifests as a symptom in these situations.
On its own, it should not be a cause for alarm.
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