Literature DB >> 25314648

Implications of a clinically ignored site of acanthosis nigricans: the knuckles.

M Gómez-Flores1, G González-Saldivar1, Or Santos-Santos2, Na Álvarez-Villalobos3, R Rodríguez-Gutiérrez2, Ca Tellez-Hinojosa2, Jg González-González2.   

Abstract

BACKGROUND: The clinical epidemiology of acanthosis nigricans (AN) has not been entirely studied. Most studies mention only its prevalence taking any "typical site" as a whole. These studies were carried out at different ages, races, anthropometries, and skin phototypes without analyzing the comparative clinical connotation of different sites. Furthermore, it has never been explored as a potential early expression of insulin resistance before it becomes clinically evident. The objective was to determine the prevalence and body distribution of AN in easy-access sites to physical examination in a Latin American youth population and its clinical implications as an early marker for obesity. DESIGN AND PATIENTS: We conducted a prospective, cross-sectional, observational study in 703 randomly selected students. Participants' mean age was 19.1±1.68 years. Overweight and obesity occurred in 23.6% and 6.8%, respectively. 3 observers blindly assessed neck, axillae, elbow and knuckles.
RESULTS: AN was identified in any of the examined sites in 47.8% of the participants. Its prevalence increased from 41% to 86% from normal to obese anthropometric categories. AN occurred in 1-4 sites in 23.1%, 10.8%, 6.9% and 7.1% of cases, respectively. The knuckles was the site with the highest prevalence of AN as an overall group (31.3%) and in the normal (24.9%) and overweight body mass index (46.4%) categories and there was a higher prevalence in the cases above the median in the normal body mass index category. In the obese group, AN was slightly more common in the neck but all sites had a very similar high prevalence.
CONCLUSION: AN occurs with a high prevalence in Latin American youths, and its prevalence is much higher in a "non-classical" and ignored location where it is very easy to detect during physical examination: the knuckles. It may also occur earlier in this location in the evolution to obesity. The presence of AN in the knuckles in any patient, even if they have a normal body mass index, might indicate the likelihood of an early clinical manifestation of insulin resistance and metabolic consequences. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

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Mesh:

Year:  2014        PMID: 25314648     DOI: 10.1055/s-0034-1387732

Source DB:  PubMed          Journal:  Exp Clin Endocrinol Diabetes        ISSN: 0947-7349            Impact factor:   2.949


  6 in total

Review 1.  Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges.

Authors:  Hak Yung Ng
Journal:  Adolesc Health Med Ther       Date:  2016-12-16

2.  Early Clinical Expressions of Insulin Resistance: The Real Enemy to Look For.

Authors:  René Rodríguez-Gutiérrez; Alejandro Salcido-Montenegro; José Gerardo González-González
Journal:  Diabetes Ther       Date:  2017-12-05       Impact factor: 2.945

Review 3.  Skin Manifestations of Insulin Resistance: From a Biochemical Stance to a Clinical Diagnosis and Management.

Authors:  Gloria González-Saldivar; René Rodríguez-Gutiérrez; Jorge Ocampo-Candiani; José Gerardo González-González; Minerva Gómez-Flores
Journal:  Dermatol Ther (Heidelb)       Date:  2016-12-05

4.  Association of Acanthosis Nigricans and Insulin Resistance in Indian Children and Youth - A HOMA2-IR Based Cross-Sectional Study.

Authors:  T M Nithun; P S S Ranugha; Jayadev B Betkerur; Veeranna Shastry
Journal:  Indian Dermatol Online J       Date:  2019 May-Jun

5.  Acanthosis Nigricans in the Knuckles of Infants: A Novel Clinical Marker of High Metabolic Risk.

Authors:  René Rodríguez-Gutiérrez; Manuel E de la O-Cavazos; Alejandro Salcido-Montenegro; Adriana Sanchez-Garcia; Minerva Gomez-Flores; Victoria Gonzalez-Nava; Dalia Castillo-Gonzalez; Karla M Santos-Santillana; José Gerardo González-González
Journal:  Diabetes Ther       Date:  2019-10-10       Impact factor: 2.945

6.  Acanthosis nigricans in the knuckles: An early, accessible, straightforward, and sensitive clinical tool to predict insulin resistance.

Authors:  Gloria González-Saldivar; René Rodríguez-Gutiérrez; Andrés Marcelo Treviño-Alvarez; Minerva Gómez-Flores; Juan Montes-Villarreal; Neri Alejandro Álvarez-Villalobos; Anasofía Elizondo-Plazas; Alejandro Salcido-Montenegro; Jorge Ocampo-Candiani; José Gerardo González-González
Journal:  Dermatoendocrinol       Date:  2018-05-21
  6 in total

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