Anupam Das1, Debatri Datta2, Martin Kassir3, Uwe Wollina4, Hassan Galadari5, Torello Lotti6, Mohammad Jafferany7, Stephan Grabbe8, Mohamad Goldust9,10,11. 1. Department of Dermatology, KPC Medical College and Hospital, Kolkata, India. 2. Oliva Skin and Hair Clinic, Kolkata, India. 3. Worldwide laser institute, Dallas, TX, USA. 4. Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany. 5. College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE. 6. University of Studies Guglielmo Marconi, Rome, Italy. 7. College of Medicine, Central Michigan University, Saginaw, MI, USA. 8. Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany. 9. University of Rome G. Marconi, Rome, Italy. 10. Department of Dermatology, University Medical Center Mainz, Mainz, Germany. 11. Department of Dermatology, University Hospital Basel, Basel, Switzerland.
Abstract
BACKGROUND: Acanthosis nigricans (AN) is a cutaneous disorder characterized by symmetric velvety hyperpigmented plaques on intertriginous areas like axilla, neck, inframammary, and groin. AIMS: To summarize the pathophysiology and classification of AN, provide an update of diagnostic testing strategies, and describe the current therapeutic options described so far in the literature for this disease. METHODS: A comprehensive english language literature search across multiple databases (PubMed, EMBASE, MEDLINE, and Cochrane) for keywords (alone and in combination) was performed. MeSH as well as non-MeSH terms such as "acanthosis nigricans," "classification," "pathophysiology," "diagnosis," "treatment," "topical drugs," "systemic drugs," "chemical peeling," and "lasers" were taken into consideration. RESULTS: The pathophysiology of AN revolves around a multifactorial stimulation of proliferation of epidermal keratinocytes and dermal fibroblasts. Various types of AN include benign, obesity-associated, syndromic, malignant, acral, unilateral, medication-induced, and mixed-type. Homeostasis model assessment-insulin resistance (HOMA-IR) is a good tool for assessment of insulin resistance. Management involves general measures (weight reduction and addressing the underlying cause, if any), topical drugs (retinoids, vitamin D analogs, and keratolytics), oral drugs (retinoids and insulin sensitizers), chemical peels (trichloroacetic acid), and lasers (Long pulsed alexandrite, fractional 1550-nm erbium fiber, and CO2 ). CONCLUSION: Acanthosis nigricans is a treatable condition; however, complete cure and disappearance of lesions are difficult to achieve. Weight reduction is the most scientific and practical management strategy. Long-term studies and further research is warranted in the pathophysiology and treatment of this common condition.
BACKGROUND:Acanthosis nigricans (AN) is a cutaneous disorder characterized by symmetric velvety hyperpigmented plaques on intertriginous areas like axilla, neck, inframammary, and groin. AIMS: To summarize the pathophysiology and classification of AN, provide an update of diagnostic testing strategies, and describe the current therapeutic options described so far in the literature for this disease. METHODS: A comprehensive english language literature search across multiple databases (PubMed, EMBASE, MEDLINE, and Cochrane) for keywords (alone and in combination) was performed. MeSH as well as non-MeSH terms such as "acanthosis nigricans," "classification," "pathophysiology," "diagnosis," "treatment," "topical drugs," "systemic drugs," "chemical peeling," and "lasers" were taken into consideration. RESULTS: The pathophysiology of AN revolves around a multifactorial stimulation of proliferation of epidermal keratinocytes and dermal fibroblasts. Various types of AN include benign, obesity-associated, syndromic, malignant, acral, unilateral, medication-induced, and mixed-type. Homeostasis model assessment-insulin resistance (HOMA-IR) is a good tool for assessment of insulin resistance. Management involves general measures (weight reduction and addressing the underlying cause, if any), topical drugs (retinoids, vitamin D analogs, and keratolytics), oral drugs (retinoids and insulin sensitizers), chemical peels (trichloroacetic acid), and lasers (Long pulsed alexandrite, fractional 1550-nm erbium fiber, and CO2 ). CONCLUSION:Acanthosis nigricans is a treatable condition; however, complete cure and disappearance of lesions are difficult to achieve. Weight reduction is the most scientific and practical management strategy. Long-term studies and further research is warranted in the pathophysiology and treatment of this common condition.
Authors: Remya Sudevan; S Vijay Kumar; Clint Sunny; Nanditha Sunand; Anu Vasudevan; Sonu K S; Apsy P V Journal: J Family Med Prim Care Date: 2021-11-29
Authors: Ana I Burguete-García; Alan Gilberto Ramírez Valverde; Meztli Espinoza-León; Isaac Sánchez Vázquez; Evelyn Yazmín Estrada Ramírez; Itzel Maldonado-López; Alfredo Lagunas Martínez; Cinthya Estefhany Diaz Benítez; Roberto Karam Araujo; Diana Fernández-Madinaveitia; Adriana E Anides Fonseca; Miguel Cruz; José de Jesús Peralta Romero Journal: Dermatol Res Pract Date: 2022-03-28