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Acanthosis Nigricans : Causes-Symptoms-Diagnosis-Treatment


What are Acanthosis Nigricans?

Acanthosis nigricans is a skin condition in which a velvety papillomatous overgrowth of the epidermis occurs. This leads to darkening and thickening (hyperkeratosis) of the skin mainly in the flexural areas, such as the axillae groins, inframammary regions, and the neck.

What are Acanthosis Nigricans?
Acanthosis Nigricans

Acanthosis nigricans is usually a sign of an underlying condition or disease, such as obesity or diabetes (benign). However, its presence as a sign of internal cancer is very rare.

  1. Integumentary system

  1. Mammary glands

  2. Skin

  3. Subcutaneous tissue

Medical terms

  • Acanthosis nigricans may be a skin condition characterized by areas of dark, velvety discoloration in body folds and creases. The affected skin will become thickened. Most often, skin condition affects your armpits, groin and neck.

  • The skin changes of skin condition (ak-an-THOE-sis NIE-grih-kuns) generally occur in folks that square measure corpulent or have polygenic disease. youngsters WHO develop the condition square measure at higher risk of developing sort two polygenic disease. Rarely, skin condition will be a serious warning call of a cancerous tumor in an interior organ, like the abdomen or liver.

  • No specific treatment is obtainable for skin condition. Treatment of underlying conditions could restore a number of the traditional color and texture to affected areas of skin.

  • nigricans nigricans is a skin condition that causes the skin to darken in areas where there would normally be folds of fat. Acanthosis nigricans is most commonly found in the back of the neck and upper arms although it can also appear on other parts of the body. nigricans appear in people with type 2 diabetes (the most common form) or sometimes due to cancer treatments, but some people do not have underlying health problems and acanthosis nigricans only occurs without an apparent cause.

  • Acanthosis nigricans (AN) often appear in the folds of the skin and under the arms in these areas it sometimes appears as velvety brown or black macules or flat macules 1-5 mm in diameter. Severely specific anorexia nervosa may be associated with insulin resistance (insulin resistance is observed in 75% of patients) and in addition to cutaneous findings, a variety of systemic symptoms including acanthosis nigricans may occur in hyperpigmented male genitalia and palms.

Who gets acanthosis nigricans?

  • Acanthosis nigricans affects a minority of Caucasians, African Americans, Latinos, and Native Americans.

  • This condition is seen in both males and females of all ages, but is more common in people aged 40 or younger.

  • Acanthosis nigricans (a blackish, fatty deposit) was found in 18.2% of children and 19.5% of adults in a cross-sectional study. Those with acanthosis nigricans were 2x as likely to have type 2 diabetes than those without (35.4% vs. 17.6%).

  • Patients with malignant acanthosis nigricans are usually middle-aged, not obese, and lesions typically develop abruptly.

What causes the skin condition called acanthosis nigricans?

The exact cause is still unknown, but it is primarily connected to states of insulin resistance where obesity, diabetes, or other metabolic disorders (for example, metabolic syndrome, polycystic ovary syndrome, generalized lipodystrophy) coexist.

Insulin crosses the skin-epidermis boundary and in high concentrations can have growth-stimulating effects by binding to type 1 insulin-like growth factor receptors (IGFRs) on keratinocytes. This stimulates the proliferation of these cells, leading to Acanthosis Nigricans.

Other rarer benign types include:

  • Drug-induced acanthosis nigricans:

    • Associated drugs include (but are not limited to) topical medications such as nicotinic acid lotion, fusidic acid ointment, oral contraceptives, oral corticosteroids, hormones (such as diethylstilbestrol or testosterone), and triazine and aripiprazole.

  • Hereditary benign acanthosis nigricans:

    • This condition is a rare autosomal dominant disorder that starts during early childhood and progresses until puberty. It is caused by a mutation in the fibroblast growth factor receptor 3.

  • Autoimmune acanthosis nigricans:

    • Some conditions are associated with olive oil, such as systemic lupus erythematosus, Sjögren syndrome, and Hashimoto's thyroiditis.

  • Acral acanthotic anomaly:

    • This condition typically occurs in darker skin types and is limited to the elbows, knees, and dorsal aspects of the hands and feet.

  • Unilateral acanthosis nigricans:

    • Naevoid acanthosis nigricans is a rare autosomal dominant skin disorder that causes lesions to occur on one side of the body along Blaschko lines. It can show up in infancy, childhood, or adulthood.

Rare malignant nigricans is:

  • The growth of tumors may be due to the release of stimulatory growth factors.

  • Gastric cancer is typically caused by a disease in the stomach.

  • Other types of cancers include liver cancer, squamous cell carcinoma, malignant melanoma, and Wilms tumor.

  • Oral cavity involvement is common in cases of cancer.

  • Tripe palms are a variant with a high association with cancer.

What are the signs and symptoms of acanthosis nigricans?

  • Patches of thick, brown skin will develop symmetrically on the skin. These patches may also form plaques.

    • In the intertriginous areas (the areas between the arms and legs, on the inside of the thighs, and on the back of the neck), most people get patches.

    • On women's nipples and between their vaginal and perineal areas areola areola (nipples), vulva (vagina), and perineum

    • Malignant acanthosis nigricans often affect the oral cavity, nasal and laryngeal mucosa, and esophagus. These areas are usually more affected in size and severity than other parts of the body.

  • Skin tags are common on skin and mucous surfaces.

  • If lesions grow, they may become macerated (covered in bacteria) or malodorous (smelly).

  • Malignant acanthosis nigricans may cause itching.

What are the different clinical features that may be seen in different types of skin?

  • The skin may appear darker in people with darker skin phenotypes.

  • People with skin phototype IV have a higher frequency of dark spots on the neck than people with skin phototypes II and III.

  • People with light skin who have acanthosis nigricans (a thick, black layer on the skin) have a high chance of having insulin resistance. However, people with skin color may have acanthosis nigricans without also having insulin resistance. This means the skin phenotype (color) affects the likelihood of developing this condition. Nigricans are a predictor of insulin resistance.

What are the possible complications of having acanthosis nigricans?

  • Cosmetic disfigurement.

  • Psychological distress.

  • Acanthosis nigricans is a risk factor for diabetes, which is an independent condition.

  • There are potential complications associated with an underlying disease, such as obesity-associated problems.

How are acanthosis nigricans diagnosed?

  • The diagnosis is made by observing the patient and taking into account their medical history, as well as the family's medical history and medications.

  • If there is any doubt about the diagnosis, a biopsy can be sent for histopathological analysis to confirm the diagnosis.

  • If someone's health deteriorates quickly, it might be a sign that there is an underlying cancer. This might require a history exam and investigations to determine the cause.

What are some possible causes of Acanthosis Nigricans?

  • Coordinated and reticulated papillomatosis: is more common in females aged 18-21 years. Heterogeneous distribution of pigment is not a hallmark of acanthosis nigricans.

  • Erythrasma: This is a red patch on the skin that can be marked by scaling and is most commonly found in the intertriginous regions. A Wood lamp exam will show fluorescence in a coral-red color, which can help to distinguish it.

  • Erythema: an inflammation with red, itchy areas. It is nonspecific and can worsen in humidity. If you have had a history of itching, the appearance of the skin may also be helpful in distinguishing it.

  • Postinflammatory hyperpigmentation is localized to the area of skin inflammation, and it may be associated with a history of skin trauma or irritation.

  • Tinea versicolor: If someone has hyperpigmented tinea versicolor on their neck, it can be difficult to tell apart from acanthosis nigricans. differentiation can be made by the presence of skin scales and mycology (the study of fungi).

What is the treatment for obesity? Acanthosis nigricans is a skin condition that results in patches of thick, black skin. Obesity is a condition in which the body accumulates too much fat. Treatment for acanthosis nigricans may include diet and exercise, while treatment for obesity may include diet and exercise as well as medication.

Treatment for the disease depends on managing the underlying cause. Patients need to be educated about the disease as well.

General measures

  • Non-medical treatment includes modifying one's lifestyle, such as eating a healthy diet and exercising to help attenuate insulin resistance and hyperinsulinemia.

  • Metformin and rosiglitazone have been used to lower insulin levels and improve the lesions.

  • Malignant acanthosis nigricans should be treated with care so that the cancer can be diagnosed and managed. Cyproheptadine can help reduce the symptoms of acanthosis nigricans that are caused by the cancer, since it inhibits the release of tumor-produced substances.

  • If you believe that your child is taking a drug that may be causing their skin to become darkened and thick, you can try to discontinue using the drug and see if that resolves the issue.

  • Treatment of an underlying syndrome can improve syndromic acanthosis nigricans (SAN). For example, using oral contraceptives to treat polycystic ovary syndrome.

Specific measures

Treating acanthosis nigricans lesions can also be done for cosmetic reasons. Pharmacological treatments can include:

  • Keratolytic agents: salicylic acid, glycolic acid, or trichloroacetic acid

  • Topical retinoids: adapalene gel or tretinoin cream can be used to treat acne.

  • Calcipotriol

  • Omega 3 fatty acids (fish oil)

  • Podophyllin

Procedural modalities include:

  • Psoralen plus UVA (PUVA)

  • Dermabrasion

  • Long-pulsed alexandrite laser therapy.

What are the consequences of having acanthosis nigricans?

The outcome of this condition depends on the cause. If the underlying cause can be addressed, for example, if weight loss is successful, then the acanthosis nigricans may resolve. Obesity, metabolic syndrome, and diabetes have harmful effects on overall health and mortality. Hereditary acanthosis may stabilize and even regress spontaneously on its own. Sometimes, malignant acanthosis nigricans are associated with a poorer prognosis (average survival time is 2 years) with early death often due to advanced cancer.

How do dermatologists treat acanthosis nigricans?

nigricans nigricans (AN) is a skin condition that sometimes causes thickening of the skin in certain places, most commonly in the neck and armpit area, but can also appear behind the ears or around the groin area. Type 2 as well as people who are overweight happen when excess melanin pigment forms on skin cells causing them to grow abnormally or swell. "

What is the best cream for acanthosis nigricans?

The difference between the two creams lies in the formulations and dosages, a lower concentration of lactic acid is suitable for mild cases while higher concentrations can be used to treat more severe cases of acanthosis nigricans. Spots and skin discoloration associated with this skin condition Although the best treatment plan is one that combines natural remedies and conventional medical treatments, there are no known side effects using either product in the prescribed dosages.

Do acanthosis nigricans always mean diabetes?

No nigricans nigricans is a general term for changes in the skin associated with insulin resistance and obesity (obese patients are more likely to develop acanthosis nigricans) If a person has acanthosis nigricans, they will also have high blood sugar and an increased risk of developing diabetes Type 2 however, some people have acanthosis nigricans without high blood glucose levels and it is also possible to develop type 2 diabetes without acanthosis nigricans.

Acanthosis nigricans

Symptoms of nigricans is a skin problem characterized by dark-colored spots on the armpits and groin. Disease within the affected area Cancerous lesions are usually painful due to the growth of abnormal cells in the affected tissue

Acanthosis nigricans in children

Acanthosis Nigricans is the name for a skin condition in which spots appear in various places on the body including folds of the skin such as the neck, groin, underarms and around the breast. The spots can also be found across joints or flexed areas where there is increased friction. They begin as brown spots but get darker and larger over time. . It is more common in people who have diabetes. Obesity is another factor that increases the risk of developing this rash. But most of the time these rashes do not pose a threat to your health

How do you treat a dark neck?

If your face is fair and you have a dark neck the key to looking better is to even out your skin tone Using an exfoliating scrub can help remove dead cells from your skin's surface making it appear brighter and more youthful You also need to use a tinted sunscreen because UV rays cause sagging

Diagnosis Acanthosis Nigricans

Acanthosis nigricans may be detected at some stage in a pores and skin examination. To be sure of the analysis, your fitness care company might take a skin pattern (biopsy) to examine below a microscope. Or you could want different tests to discover what is inflicting your signs.

  1. Blood analysis

  2. Blood count

  3. Blood typing

Treatment Acanthosis Nigricans

There's no specific remedy for acanthosis nigricans. Your care issuer might propose remedies to help with pain and smell, along with pores and skin lotions, special soaps, medicinal drugs and laser remedy.

Treating the underlying motive may help. Examples consist of:

  • Lose weight. If your acanthosis nigricans are caused by weight problems, dietary counseling and losing weight may assist.

  • Stop medications. If your circumstance appears to be associated with a medication or complement which you use, your care issuer may advocate that you stop using that substance.

  • Have surgical operation. If acanthosis nigricans was brought on by using a cancerous tumor, surgical operation to remove the tumor regularly clears up the pores and skin signs and symptoms.

Preparing for your appointment

You're likely to start by seeing your family doctor. He or she may refer you to a doctor who specializes in skin disorders (dermatologist) or hormone problems (endocrinologist). Because appointments can be brief and there's often a lot of ground to cover, it's a good idea to be well-prepared for your appointment.

What you can do

Before your appointment, you may want to list answers to the following questions:

  • Has anyone in your family ever had this problem?

  • Does diabetes run in your family?

  • Have you ever had problems with your ovaries, adrenal glands or thyroid?

  • What medications and supplements do you take on a regular basis?

  • Have you ever had to take high doses of prednisone for more than a week?

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • When did your symptoms begin?

  • Have they gotten worse?

  • What areas of your body are affected?

  • Have you ever had cancer?

General summary

  1. Yes, acanthosis nigricans is a benign condition that can go away without treatment and may also be the result of another medical problem so it is important to consult a doctor to make sure the skin changes are just a cosmetic problem and not something more serious. Unnatural changes to lifestyle and diet, however, you should talk to your doctor about appropriate treatments for acanthosis nigricans that will work best for you
  2. Acanthosis Nigricans (AN) is a condition that causes the skin, especially in the folds, to become thickened and darker. This condition is often characterized by dark, velvety patches on the neck, groin, underarms, elbows, and knees. It is benign and is not contagious. Though AN can affect people of all ages, it is more common in people who are overweight, have diabetes, or are of African descent.
  3. Acanthosis nigricans is a skin condition that is characterized by dark and velvety patches on the skin. It is typically found in the folds and creases of the body, most commonly in the armpits, neck, and groin area. Acanthosis nigricans can be caused by a number of different things, including obesity, genetics, diabetes, hormonal changes, or medications. While the condition is not harmful on its own, it is important to have it checked out by a doctor to rule out other medical conditions.
Acanthosis Nigricans : Causes-Symptoms-Diagnosis-Treatment

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