Acanthosis Nigricans

Overview

Acanthosis nigricans is a condition that commonly affects the body folds. It causes them to become dark, thick and velvety. The most commonly affected folds are the groined, armpits and neck.

Acanthosis nigricans is a rare condition and usually affects obese people. It can also be a sign of cancer in internal organs, such as the stomach or the liver.

Causes

There is no exact cause of acanthosis nigricans. However, some conditions that might be related to it include:

• Insulin resistance: Most people diagnosed with acanthosis nigricans become insulin resistant. However, it is not yet clear which comes first.
• Certain drugs and supplements: High doses of certain supplements or medicine may cause acanthosis nigricans—for example, birth control pills, niacin, prednisone and other corticosteroids.
• Cancer: Some types of cancer may lead to acanthosis nigricans—for example, the colon, stomach, and liver lymphoma and cancers.

Symptoms

Acanthosis nigricans is a slowly developing disease characterised by the dark, velvety and thick skin of the body folds and creases. It commonly affects the groyne, armpits and back of the neck. The skin often becomes itchy, may have an odour or develop skin tags and moles.

Diagnosis

The condition is simple to diagnose and often does not require any lab tests. Instead, it is diagnosed by carefully examining the skin, taking a proper medical history and performing a physical exam.

Treatment

There is no exact treatment for Acanthosis nigricans. Only symptomatic relief can be given to the patient, which includes using topical creams, soaps and medicines for treating pain and odour. Alternatively, laser therapy can be employed to improve the patient’s clinical symptoms.

Treatment of the underlying causes also helps improve the condition of people with acanthosis nigricans. For example:

• Losing weight: If acanthosis nigricans is associated with obesity, it is imperative to consult a nutritional counsellor to shed extra body mass. This will prevent or eliminate folds in the body.
• Stopping medications: If the condition appears due to a medication or supplement that is regularly taken, the doctor may advise stopping the use of that supplement. As a result, the condition will resolve itself.
• Opt for surgery: If acanthosis nigricans is triggered by a malignant tumour, surgery may be needed to remove the tumour. Consequently, the skin becomes clear and asymptomatic.

Other treatment modalities include Retin-A, alpha hydroxy acids, 20% urea, topical vitamin D and salicylic acid prescriptions. They are not very useful, in most cases.

Prevention

The prevention of atherosclerosis depends on the condition it is related to. For people with obesity, management of their weight is essential. Other medical conditions associated with acanthosis nigricans, like hypothyroidism, need to be treated alongside.