Abstract
Acanthosis nigricans (AN) is a common skin condition characterized by velvety hyperpigmented skin, most commonly noted in the intertriginous areas such as the neck and axillae. Clinical recognition of AN is essential because AN is associated with a variety of systemic and metabolic disorders, many of which are characterized by obesity and/or insulin resistance. Children with AN should be screened for diabetes and other comorbidities of obesity. Treatment involves addressing the underlying factors. Weight loss and improvement in insulin sensitivity may result in resolution of AN.
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References
Pollitzer S. Acanthosis nigricans: a symptom of a disorder of the abdominal sympathetic. JAMA. 1909;53:1369–73.
Sinha S, Schwartz RA. Juvenile acanthosis nigricans. J Am Acad Dermatol. 2007;57(3):502–8.
Robinson SS, Tasker S. Acanthosis nigricans juvenilis associated with obesity; report of a case, with observations on endocrine dysfunction in benign acanthosis nigricans. Arch Dermatol Syphilol. 1947;55(6):749–60.
Jeong JS, Lee JY, Yoon TY. Unilateral nevoid acanthosis nigricans with a submammary location. Ann Dermatol. 2011;23(1):95–7.
Schwartz RA, Janniger CK. Childhood acanthosis nigricans. Cutis. 1995;55(6):337–41.
Higgins SP, Freemark M, Prose NS. Acanthosis nigricans: a practical approach to evaluation and management. Dermatol Online J. 2008;14(9):2.
Berk DR, Spector EB, Bayliss SJ. Familial acanthosis nigricans due to K650T FGFR3 mutation. Arch Dermatol. 2007;143(9):1153–6.
Hirai H, et al. Acanthosis nigricans in a Japanese boy with hypochondroplasia due to a K650T mutation in FGFR3. Clin Pediatr Endocrinol. 2017;26(4):223–8.
Koyama S, et al. Transforming growth factor-alpha (TGF alpha)-producing gastric carcinoma with acanthosis nigricans: an endocrine effect of TGF alpha in the pathogenesis of cutaneous paraneoplastic syndrome and epithelial hyperplasia of the esophagus. J Gastroenterol. 1997;32(1):71–7.
Karadag AS, et al. Acanthosis nigricans and the metabolic syndrome. Clin Dermatol. 2018;36(1):48–53.
Rafalson L, Eysaman J, Quattrin T. Screening obese students for acanthosis nigricans and other diabetes risk factors in the urban school-based health center. Clin Pediatr (Phila). 2011;50(8):747–52.
Hud JA Jr, et al. Prevalence and significance of acanthosis nigricans in an adult obese population. Arch Dermatol. 1992;128(7):941–4.
Friedman CI, Richards S, Kim MH. Familial acanthosis nigricans. A longitudinal study. J Reprod Med. 1987;32(7):531–6.
Schmidt TH, et al. Cutaneous findings and systemic associations in women with polycystic ovary syndrome. JAMA Dermatol. 2016;152(4):391–8.
Jabbour SA. Cutaneous manifestations of endocrine disorders: a guide for dermatologists. Am J Clin Dermatol. 2003;4(5):315–31.
Schwartz RA. Acanthosis nigricans. J Am Acad Dermatol. 1994;31(1):1–19; quiz 20–2.
Arioglu E, et al. Clinical course of the syndrome of autoantibodies to the insulin receptor (type B insulin resistance): a 28-year perspective. Medicine (Baltimore). 2002;81(2):87–100.
Baird JS, et al. Systemic lupus erythematosus with acanthosis nigricans, hyperpigmentation, and insulin receptor antibody. Lupus. 1997;6(3):275–8.
Torley D, Bellus GA, Munro CS. Genes, growth factors and acanthosis nigricans. Br J Dermatol. 2002;147(6):1096–101.
Munoz-Perez MA, Camacho F. Acanthosis nigricans: a new cutaneous sign in severe atopic dermatitis and Down syndrome. J Eur Acad Dermatol Venereol. 2001;15(4):325–7.
Krawczyk M, Mykala-Ciesla J, Kolodziej-Jaskula A. Acanthosis nigricans as a paraneoplastic syndrome. Case reports and review of literature. Pol Arch Med Wewn. 2009;119(3):180–3.
Pentenero M, et al. Oral acanthosis nigricans, tripe palms and sign of leser-trelat in a patient with gastric adenocarcinoma. Int J Dermatol. 2004;43(7):530–2.
Anderson SH, Hudson-Peacock M, Muller AF. Malignant acanthosis nigricans: potential role of chemotherapy. Br J Dermatol. 1999;141(4):714–6.
Skiljevic DS, et al. Generalized acanthosis nigricans in early childhood. Pediatr Dermatol. 2001;18(3):213–6.
Birns J, et al. Acanthosis nigricans associated with acute myeloid leukaemia. Eur J Intern Med. 2004;15(7):473.
Garrott TC. Malignant acanthosis nigricans associated with osteogenic sarcoma. Arch Dermatol. 1972;106(3):384–5.
Bhargava P, et al. Malignant acanthosis nigricans in a 2 year old child with Wilm’s Tumour. Indian J Dermatol Venereol Leprol. 1998;64(1):29–30.
Stals H, et al. Acanthosis nigricans caused by nicotinic acid: case report and review of the literature. Dermatology. 1994;189(2):203–6.
Fleming MG, Simon SI. Cutaneous insulin reaction resembling acanthosis nigricans. Arch Dermatol. 1986;122(9):1054–6.
Skouby SO. Update on the metabolic effects of oral contraceptives. J Obstet Gynaecol (Lahore). 1986;6(Suppl 2):S104–9.
Mellor-Pita S, et al. Acanthosis nigricans: a new manifestation of insulin resistance in patients receiving treatment with protease inhibitors. Clin Infect Dis. 2002;34(5):716–7.
Manu P, et al. Acanthosis nigricans during treatment with aripiprazole. Am J Ther. 2014;21(3):e90–3.
Krishnaram AS. Unilateral nevoid acanthosis nigricans. Int J Dermatol. 1991;30(6):452–3.
Schwartz RA. Acral acanthosis nigricans (acral acanthotic anomaly). J Am Acad Dermatol. 2007;56(2):349–50.
Arslanian S, et al. Evaluation and Management of Youth-Onset Type 2 diabetes: a position statement by the American Diabetes Association. Diabetes Care. 2018;41(12):2648–68.
Buse JB, et al. Diabetes screening with hemoglobin A(1c) versus fasting plasma glucose in a multiethnic middle-school cohort. Diabetes Care. 2013;36(2):429–35.
Chan WK, et al. Limited utility of plasma M30 in discriminating non-alcoholic steatohepatitis from steatosis--a comparison with routine biochemical markers. PLoS One. 2014;9(9):e105903.
Kohli R, et al. Pediatric nonalcoholic fatty liver disease: a report from the expert committee on nonalcoholic fatty liver disease (ECON). J Pediatr. 2016;172:9–13.
Cook S, Kavey RE. Dyslipidemia and pediatric obesity. Pediatr Clin N Am. 2011;58(6):1363–73, ix.
Expert Panel on Integrated Guidelines for Cardiovascular Health. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011;128(Suppl 5):S213–56.
Sharma A, et al. Diagnostic thresholds for androgen-producing tumors or pathologic hyperandrogenism in women by use of Total testosterone concentrations measured by liquid chromatography-tandem mass spectrometry. Clin Chem. 2018;64(11):1636–45.
Rosenfield RL, et al. Antimullerian hormone levels are independently related to ovarian hyperandrogenism and polycystic ovaries. Fertil Steril. 2012;98(1):242–9.
Elhassan YS, et al. Causes, patterns, and severity of androgen excess in 1205 consecutively recruited women. J Clin Endocrinol Metab. 2018;103(3):1214–23.
Lavery GG, et al. Steroid biomarkers and genetic studies reveal inactivating mutations in hexose-6-phosphate dehydrogenase in patients with cortisone reductase deficiency. J Clin Endocrinol Metab. 2008;93(10):3827–32.
Bellot-Rojas P, et al. Comparison of metformin versus rosiglitazone in patients with acanthosis nigricans: a pilot study. J Drugs Dermatol. 2006;5(9):884–9.
Romo A, Benavides S. Treatment options in insulin resistance obesity-related acanthosis nigricans. Ann Pharmacother. 2008;42(7):1090–4.
Legro RS, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(12):4565–92.
Martin KA, et al. Evaluation and treatment of hirsutism in premenopausal women: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(4):1233–57.
Cremer M, Phan-Weston S, Jacobs A. Recent innovations in oral contraception. Semin Reprod Med. 2010;28(2):140–6.
Bagis T, et al. The effects of short-term medroxyprogesterone acetate and micronized progesterone on glucose metabolism and lipid profiles in patients with polycystic ovary syndrome: a prospective randomized study. J Clin Endocrinol Metab. 2002;87(10):4536–40.
Tercedor J, et al. Effect of ketoconazole in the hyperandrogenism, insulin resistance and acanthosis nigricans (HAIR-AN) syndrome. J Am Acad Dermatol. 1992;27(5 Pt 1):786.
Coates P, Shuttleworth D, Rees A. Resolution of nicotinic acid-induced acanthosis nigricans by substitution of an analogue (acipimox) in a patient with type V hyperlipidaemia. Br J Dermatol. 1992;126(4):412–4.
Lunetta M, et al. Long-term octreotide treatment reduced hyperinsulinemia, excess body weight and skin lesions in severe obesity with acanthosis nigricans. J Endocrinol Investig. 1996;19(10):699–703.
Sherertz EF. Improved acanthosis nigricans with lipodystrophic diabetes during dietary fish oil supplementation. Arch Dermatol. 1988;124(7):1094–6.
Darmstadt GL, Yokel BK, Horn TD. Treatment of acanthosis nigricans with tretinoin. Arch Dermatol. 1991;127(8):1139–40.
Ichiyama S, et al. Effective treatment by glycolic acid peeling for cutaneous manifestation of familial generalized acanthosis nigricans caused by FGFR3 mutation. J Eur Acad Dermatol Venereol. 2016;30(3):442–5.
Rosenbach A, Ram R. Treatment of acanthosis nigricans of the axillae using a long-pulsed (5-msec) alexandrite laser. Dermatol Surg. 2004;30(8):1158–60.
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Saleh, M., Muzumdar, R. (2021). Acanthosis Nigricans. In: Stanley, T., Misra, M. (eds) Endocrine Conditions in Pediatrics. Springer, Cham. https://doi.org/10.1007/978-3-030-52215-5_18
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DOI: https://doi.org/10.1007/978-3-030-52215-5_18
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