Acanthosis nigricans

Other conditions associated with insulin resistance (e.g., acanthosis nigricans)5... 

Presence of acne, hirsutism, hair loss, or acanthosis nigricans may suggest androgen excess. 

Acanthosis nigricans A skin condition characterized by dark, thickened velvety patches, especially in the folds of skin in the armpits, groin, and back of the neck that is often associated with insulin resistance. Also may be associated with internal malignancy, endocrine disorders, and obesity. 

Dermatologic Acanthosis nigricans, dry skin, itching, pruritus, rash, sensation of warmth, severe generalized flushing, tingling. 

There has been one previous report of acanthosis nigricans in a woman who received human pituitary extract (62). This condition is usually seen in hyperinsulinemic states, including diabetes mellitus and acromegaly over-stimulation at the IGF-I receptor is probably the final common pathway. 

Downs AM, Kennedy CT. Somatotrophin-induced acanthosis nigricans. Br J Dermatol 1999 141(2) 390-1. Nordlund JJ, Lerner AB. Cause of acanthosis nigricans. N Engl J Med 1975 293(4) 200. 

Of 61 patients with ischemic heart disease and dyslipi-demia treated with nicotinic acid 1.5 and 3.0 g/day, 32 patients were withdrawn, 18 because of adverse effects and 14 for reasons not related to nicotinic acid (32). Of the 29 patients who finished the study, adverse effects included dryness of the skin (14%), acanthosis nigricans (10%), fatigue (6.9%), nausea (6.9%), abdominal pain (3.4%), diarrhea (3.4%), and anorexia (3.4%) the figures in parentheses were the incidences at 33 weeks. Flushing occurred more often at 18 weeks than at 33 weeks (24 versus 6.9%), as did pruritus (35 versus 28%), suggesting tolerance to these effects. 

Nicotinic acid disturbs the normal cornification of the skin, occasionally leading to reversible ichthyosis and acanthosis nigricans (SEDA-19, 206). Two mechanisms are advanced to explain this effect insulin resistance induced by nicotinic acid, with compensatory hyperinsu-linemia (which in turn leads to increased insulin binding to insulin-like growth factor receptors and stimulation of keratinocytes), or a disturbance of epidermal lipid homeostasis. 

Skin problems can be persistent in a proportion of patients, variously estimated at 10-59%, and this can severely limit adherence to therapy. The skin reaction can be ameliorated by concomitant use of non-steroidal anti-inflammatory drugs such as aspirin and indometacin (SEDA-15, 412). Transient exanthems, pruritus, and sometimes wheals are seen, as well a uniform dryness and scaling of the epidermis, brown pigmentation, and even on occasion an acanthosis nigricans-like dermatosis (15). Persistent rashes can also occur. Doses in excess of 5 g/day are routinely associated with skin manifestations and can on occasion cause liver damage, gout and ulcer formation. These reactions can be associated with nicotinic acid rather than nicotinamide, which is sometimes recommended as an alternative (37). Increased hair loss has been described. 

Her body mass index (BMI) was 31.5 kg/m2, which is more than 97% of that for her age. Her thyroid was not enlarged, the cardiac examination was normal, and the lung examination was normal without any wheezing (a high-pitched, flutelike noise with expiration often seen with asthma). She had a dark, thick skin rash in the folds on her neck called acanthosis nigricans. 

T.F. had acanthosis nigricans, a velvety skin rash that mimics the appearance of poorly washed skin and is commonly seen in the neck folds, axilla, or under the breasts. Although this condition may be associated with type 2 diabetes, BMI is a better predicator of risk for the development of type 2 diabetes than the finding of acanthosis nigricans. 

Skin and muscles Acute rhabdomyolysis (362) as well as dermatomyositis are considered to be rare manifestations of Wilson s disease. Occasionally, there is evidence of hyperpigmentation as well as acanthosis nigricans. Bluish, lunular discolorations of the nails, so-called azure lunulae, are rare. (322) (s. p. 84)... 

Acanthosis nigricans has been associated with fusidic acid (9). 

Cairo F, Rubrno I, Rotundo R, Prato GP, Ficarra G. Oral acanthosis nigricans as a marker of internal malignancy. A case report. J Periodontol 2001 72(9) 1271-5. 

Acanthosis nigricans, which is characterized by dark velvety thickening of the skin on the nape of the neck and in the groins and axillae, has been described in a non-obese 10-year-old boy with achondroplasia who received somatropin 3 lU/week for 7 years (54). 

Downs AM, Kennedy CT. Somatotrophin-induced acanthosis nigricans. Br J Dermatol 1999 141(2) 390-1. 

Fusidic acid Antibacterial agent Acanthosis nigricans (SEDA-17, 192)... 

Nicotinic acid Treatment of alopecia Acanthosis nigricans SEDA-11, 142)... 

Fleming MG +, Arch Dermatol 122, 1054 (resembling acanthosis nigricans)... 

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