Acanthosis Nigricans Symptoms, Causes, & Treatment Options

Acanthosis nigricans is a disorder of the skin that can take place at any age. It causes velvety darkening of the skin and is often associated with obesity, diabetes, and metabolic syndrome and can be associated with certain types of cancers. Prevention and treatment of acanthosis nigricans depends on the cause.

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Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Acanthosis Nigricans?

Summary

Acanthosis nigricans is a skin disorder most frequently associated with increased obesity and increased insulin in the blood over time. It can be treated by treating the underlying cause of increased insulin which can be caused by metabolic disorders, genetic disorders, and tumors.

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Acanthosis Nigricans Symptoms

Main symptoms

The primary symptoms of acanthosis nigricans are skin changes in the flexural creases of the body or areas like the neck, armpits, or groin. The skin often changes and becomes darker, velvety, and slightly thicker over time. Other associated symptoms depend on the cause of acanthosis nigricans. Acanthosis caused by diabetes will be associated with symptoms of diabetes, acanthosis caused by malignancy will be associated with symptoms of malignancy, acanthosis caused by genetic disorders will be associated with symptoms of the associated genetic disorder.

Velvety skin in flexural areas: Acanthosis is caused when insulin receptors are upregulated in the skin and this causes excessive and altered skin growth. In instances where the disease is caused by diabetes or metabolic syndrome, it is not uncommon for affected skin to be in the groin, armpit, neck, or even the backs of the knees.

Acanthosis Nigricans Causes

Acanthosis nigricans is caused by an increase in the growth of skin cells because of increased creation of receptors (or sensors) for insulin. This increase in receptors can be caused by elevated amounts of insulin in the blood or it can be caused by elevated amounts of insulin in the blood over a long period of time or by a genetic predisposition. Elevated insulin can be genetic, caused by diet and behavior, or the product of an insulin-promoting or insulin-secreting tumor.

Metabolic Disorders

Metabolic disorders cause acanthosis nigricans by increasing the amount of insulin in the body. Typically, over a long period of exposure to foods high in sugar, the body becomes resistant to insulin (the chemical that allows the processing of sugar in the body). As the body becomes resistant to insulin, cells in different areas of the body increase the amount of insulin receptors in an attempt to increase sensitivity to the insulin signal and reduce insulin resistance. Unfortunately, the increase in these receptors also causes an increase in the growth of cells in certain areas including the crease of the back of the neck, armpits, and groin. Acanthosis nigricans is often caused by metabolic syndrome when it appears in those areas.

  • Metabolic syndrome
  • Obesity
  • Diabetes
  • Polycystic ovary syndrome

Genetic Disorders

Genetic disorders here refer to disorders caused by a single discrete gene or a combination of well-defined genes. In some of these disorders (listed below) the body has a predisposition for insulin resistance or long-standing hyperinsulinemia (an excessive amount of insulin in the blood). In some cases, these genetic disorders can result in an inability to produce sufficient insulin to control the amount of sugar in the blood.

  • Down syndrome
  • Alstrom syndrome
  • Type 1 diabetes

Malignancy

Cancers of the digestive tract and the renal system including the liver, kidney, bladder, or even the breast, ovary, and lymphatic system can contribute to the development of acanthosis nigricans. It is important to note that often acanthosis nigricans from malignancy does not exist in the same places as acanthosis from diabetes. It may occur on the lips on the face or in other areas outside of flexural creases. It has not yet been determined what causes acanthosis nigricans, but it is suspected that the secretion of growth factor by tumor cells is one of the primary mechanisms of development of skin findings.

  • Gastric adenocarcinoma
  • Prostate cancer
  • Breast cancer
  • Ovarian cancer

Medications

Mediations that affect the hormonal balance of individuals and increase the amount of insulin or other growth hormones in the blood can contribute to the development of acanthosis nigricans. Medications like hormonal contraceptives, protein pump inhibitors, or injected insulin are associated with the development of acanthosis nigricans.

  • Protein pump inhibitors
  • Niacin
  • Glucocorticoids
  • Protease inhibitors
  • Injected insulin

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Treatment Options, Relief, and Prevention for Acanthosis Nigricans

Treatment

The treatment of acanthosis nigricans depends on the cause. The most common cause of acanthosis nigricans in diabetes, in particular poorly controlled diabetes. Treatment in those cases consists of better blood sugar control which can be done by diet in less severe cases and with certain over the counter medications in more severe cases. If acanthosis is caused by a genetic disorder, the symptoms of such a disorder are treated. If it is caused by a malignancy, the malignancy should be treated or removed to reduce acanthosis nigricans. If it is caused by a medication, the offending medication should be stopped.

Prevention

Acute: The most common cause of acanthosis nigricans is diabetes. The best way to avoid acanthosis nigricans is the same way we avoid diabetes. Reducing and maintaining a healthy weight, limiting sugar intake, increasing physical activity, and even eating more vegetables and leafy greens can all keep your body functioning and capable of producing sufficient insulin.

When to Seek Further Consultation for Acanthosis Nigricans

If you are experiencing belly pain, shortness of breath, increased urination, changes in your vision, weakness, or dizziness, then you should seek evaluation for either diabetes or a malignancy.