Acanthosis nigricans: A review.

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.

• Authors: Anupam Das, Debatri Datta, Martin Kassir, Uwe Wollina, Hassan Galadari, Torello Lotti, Mohammad Jafferany, Stephan Grabbe, Mohamad Goldust
• Journal: Journal of cosmetic dermatology (J Cosmet Dermatol) Vol. 19 Issue 8 Pg. 1857-1865 (Aug 2020) ISSN: 1473-2165 [Electronic] England
• PMID: 32516476 (Publication Type: Journal Article, Review)
• Copyright: © 2020 Wiley Periodicals, LLC.

Chemical References

• Retinoids
• Vitamin D

Topics

• Acanthosis Nigricans (etiology, therapy)
• Humans
• Insulin Resistance
• Obesity
• Retinoids
• Vitamin D