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Acanthosis Nigricans

What One Should Know

Apr 9, 2009 Naheed Ali

Acanthosis nigricans (AN) is a skin disease defined by abnormally increased discoloration (hyperpigmentation) and "velvety" appearance (hyperkeratosis) of the skin.

Acanthosis nigricans occurs especially in skin fold areas, like the groin, neck and armpits. Several benign, non-cancerous, types of AN have been identified in which the disorder may be inherited as a primary condition or associated with various underlying syndromes. These include: an excess accumulation of body fat, or the use of certain medications (for example, drug-induced acanthosis nigricans).

In other cases, acanthosis nigricans can occur in connection with an underlying cancerous neoplasm or tumor (malignant acanthosis nigricans). Experts believe that acanthosis nigricans may perhaps be simply a dermatological expression of insulin resistance, which is an illness characterized by impaired biological reactions to insulin.

Looking Further into Acanthosis Nigricans

Insulin, a secretion produced internally by the pancreas, controls blood glucose amounts by promoting the transport of glucose into cells for energy purposes or into the liver and adipose tissue (fat cells) for energy reserves. Glucose is a type of sugar that is the body's main source of energy for cellular metabolic processes.

A few clinicians believe that insulin resistance brings about a build-up of the hormonal enzymes in the bloodstream that eventually find its way into skin tissue. Insulin resistance could be related to various diseases, like obesity and non-insulin-dependent (type II) diabetes mellitus.

In patients with type II diabetes mellitus, the pancreas makes insulin but the system becomes immune to its effects, eventually leading to inadequate absorption of glucose and abnormally high glucose levels in the bloodstream (hyperglycemia) and urine.

As a consequence, there could be a gradual onset of specific symptoms, including excessive urination (polyuria) and persistent thirst (polydipsia), and the development of certain complications if there is no treatment.

Acanthosis Nigricans as a Disease

Acanthosis nigricans is a disease that may strike at any age. It creates velvety, light-brown-to-black, scars usually on the neck, under the arms or in the groin region. AN is most often connected with obesity. Overeating potentially harmful foods, particularly sugars and starches, can induce insulin resistance. This will cause elevated insulin levels.

The majority of patients with acanthosis nigricans have a greater insulin level than those of the same weight without AN. Increased levels of insulin in most instances bring about acanthosis nigricans. The increased insulin levels in the body triggers insulin receptors in the skin cells, driving them to grow abnormally. Repressing the circulating insulin by dieting habits or drugs could lead to relief from this skin disease.

When AN appears in patients who are not obese, a clinical work-up should be completed. Rarely, AN is related to a neoplasm (tumor), most typically of the abdomen or bowel. In these instances, acanthosis can be discovered in extra places like the lips or hands, and is somewhat severe. At times, AN is inherited or due to an endocrine gland disease.

Prescriptions drug therapies used for simply improving the appearance of acanthosis nigricans include: alpha hydroxyacids, Retin-A, 20% urea solution, and salicylic or lactic acid medicines.