Darkening of the skin may be a sign of acanthosis nigricans. Symptoms and treatment of acanthosis nigricans How to treat acanthosis nigricans

Acanthosis nigricans or acanthosis nigricans is not a skin disease as such, but a skin symptom of an underlying disease.

There are two main types of acanthosis:

1. Benign
2. Malignant

Malignant acanthosis nigricans is quite rare and is associated with the development of cancerous tumors of internal organs. Benign types, sometimes called “pseudoacanthosis,” are much more common.

Causes of acanthosis nigricans

The cause of acanthosis nigricans is still not clearly defined, but the condition appears to be related to insulin resistance. This skin condition is associated with various benign and malignant neoplasms. Based on the causes of acanthosis nigricans, this condition has been divided into 7 types:

Type 1: Acanthosis nigricans associated with obesity

• The most common type of acanthosis nigricans.
• It can occur at any age, but is more common in adulthood.
• Obesity is often caused by insulin resistance.

Type 2: Syndromic acanthosis nigricans

Defined as acanthosis nigricans, which is associated with certain syndromes such as:

• hyperinsulinemia
• Cushing's syndrome
• polycystic ovary syndrome (PCOS)
• generalized lipodystrophy
• Crouzon syndrome

Type 3: Benign acanthosis

• Also referred to as acral acanthotic anomaly.
• A firm, velvety lesion, most noticeable on the upper surface of the arms and legs in patients in good health.
• Most often found in dark-skinned people.

Type 4: Medicinal acanthosis nigricans

This type of acanthosis nigricans can be caused by several medications, including:

• nicotinic acid
• insulin
• systemic corticosteroids
• hormonal drugs

Type 5: Hereditary benign acanthosis nigricans

• Acanthosis nigricans is inherited in an autosomal dominant manner.
• Lesions can appear at any age: infancy, childhood or adulthood.

Type 6: Malignant acanthosis nigricans

• Acanthosis nigricans associated with the development of malignant neoplasms in internal organs.
• The most common underlying cancers causing malignant acanthosis nigricans are tumors in the gastrointestinal tract (90% of cases), especially stomach cancer.
• In 25-50% of cases, lesions are present in the mouth on the tongue and lips.

Type 7: Acanthosis nigricans mixed type

Patients with one type of Acanthosis nigricans may also develop new skin lesions due to another cause, such as being overweight - this causes obesity-related acanthosis nigricans, which can then develop into a malignant form.

Symptoms

• Thickened, brown, velvety textured patches of skin that can occur anywhere on the body but most often appear in folds of skin such as the armpits, groin, and back of the neck.
• Papillomatosis (multiple formation of papillomas) is common on the surfaces of the skin and mucous membranes.
• Acrochordons, often found on and around affected areas of the skin.
• Pruritus may be present, especially in acanthosis nigricans associated with malignancy (paraneoplastic pruritus).
• Lesions may also appear on the mucous membranes of the mouth, the mucous membranes of the nose, larynx and esophagus.
• Lesions on the mucous membranes, palms, and soles tend to be more extensive and more severe in acanthosis nigricans.
• Patients with the malignant type of this condition are more often middle-aged than obese, and the lesion develops suddenly.

Diagnostics

It is very important to differentiate acanthosis nigricans associated with malignant neoplasms from diseases associated with benign conditions. Tumors in malignant acanthosis nigricans are usually very aggressive and spread quickly. Death often comes very quickly. If malignant acanthosis nigricans is suspected in a patient without a known internal cancer, it is essential to perform a thorough examination to identify malignancy and occult tumors. If the tumor can be successfully treated, the condition may be eliminated.

Other causes of acanthosis nigricans can be identified by screening for insulin resistance and diabetes.

Treatment of acanthosis nigricans

The main goal of treatment is to eliminate the underlying disease process. Often, eliminating the underlying cause will result in the skin lesions disappearing.

• Correction of hyperinsulinemia with diet and medications.
• Weight loss in acanthosis nigricans associated with obesity.
• Removal or treatment of the underlying tumor.
• Stop taking medications that cause acanthosis nigricans.

In hereditary acanthosis nigricans, the lesions tend to enlarge gradually before self-stabilizing and/or regressing.

There are no specific treatments for acanthosis nigricans. Treatments considered are used primarily to improve appearance and include topical retinoids, dermabrasion, and laser therapy.

The favorable prognosis of this skin condition is largely determined by the cause of its occurrence. Benign conditions can resolve either on their own or through lifestyle changes and/or treatment that resolve the skin lesions. However, the prognosis for patients with malignant acanthosis nigricans is often poor. The underlying cancer often evolves, and the average survival of these patients is approximately 2 years.

), characterized by hyperkeratosis (increase in thickness) and hyperpigmentation (darkening) of the skin, with the appearance of dark areas on the body, especially near the folds. In most cases, the most affected areas are the armpits, groin and neck.

Acanthosis nigricans is not contagious or dangerous, but it is sometimes a warning sign of a health problem that requires medical attention.

This dermatosis is, in fact, commonly associated with obesity, hyperinsulinemia, and polycystic ovary syndrome. Less commonly, this skin change may be a warning sign for certain cancers that affect an internal organ, such as the stomach. There is no specific treatment for acanthosis nigricans, but therapeutic treatment of the underlying disease can usually restore normal pigmentation to the affected areas.

Causes

Acanthosis nigricans may be benign or associated with an underlying malignancy.

People can develop this condition for many reasons.

Obesity and all situations characterized by excess are the main causes of acanthosis nigricans. Particularly when the appearance of skin lesions is associated with obesity, weight management is an important component of treatment: a diet that helps lower insulin levels may also help prevent acanthosis nigricans.

Benign form

Benign form mainly affects children and adults under 40 years of age, can be genetically inherited and is most often associated with endocrine disorders such as acromegaly, polycystic ovary syndrome, or insulin resistance. However, the disorder is not associated with.

Endocrine and metabolic diseases

The most common cause of acanthosis nigricans is insulin resistance, which causes an increase in the level of this hormone secreted in the blood.

May cause abnormal growth of skin cells (hyperplasia). High circulating levels of the hormone likely activate insulin-like growth factor receptor type 1 (IGF1-R), which drives the rapid proliferation of keratinocytes and melanocytes.

The condition most commonly associated with insulin resistance is type 2 diabetes, but it is also a common feature in cases of obesity and polycystic ovary syndrome. Controlling blood levels with exercise and diet often improves symptoms.

Other diseases and syndromes associated with acanthosis nigricans are:

• Donohue syndrome (a very rare congenital disorder characterized by extreme insulin resistance);
• Rabson-Mendenhall syndrome (a rare genetic disorder characterized by insulin abnormalities);
• (such as hypothyroidism);
• pituitary disorders (Cushing's syndrome, etc.);
• disorders (for example).

Medications

Acanthosis nigricans can also be caused by certain medications, such as birth control pills, diethylbestrol or thyroid medications, and even certain supplements. All of these drugs can cause changes in insulin levels, increasing their concentration.

Growth hormone therapy, systemic corticosteroids, high-dose niacin, and some medications used to relieve the side effects of chemotherapy may also contribute to acanthosis nigricans. In most cases, the condition resolves when certain medications and supplements are stopped.

Malignant forms

Acanthosis nigricans may occur less frequently as a result of specific paraneoplastic syndromes affecting the skin and mucus (stomach cancer, uterine cancer, etc.). In the context of an aggressive underlying tumor, dermatosis is therefore referred to as malignant acanthosis nigricans. Typically, this form is characterized by sudden onset and affects subjects over 40 years of age. Among the most common neoplasms are:

• adenocarcinoma of the gastrointestinal tract (especially the stomach and colon) or uterus;
• less common: lung cancer, prostate cancer, or.

Malignant acanthosis nigricans lesions are recognizable because they appear on the mucous membranes of the mouth or tongue, nasal mucosa, esophagus and larynx, and are generally unaffected by the more common benign forms.

Other reasons

Acanthosis nigricans can also occur in the presence of some genetic diseases, while in other cases the appearance of dark spots does not appear to be associated with other diseases (idiopathic cause).

Risk factors

Acanthosis nigricans can affect people of any age (including children) and all ethnic groups. However, it is more common in adults and people with darker skin, such as Native Americans, Hispanics and some African populations. Men and women suffer equally.

People most susceptible to developing acanthosis nigricans are:

• people who are overweight or obese;
• subjects with endocrine or metabolic changes;
• patients who regularly take certain medications (eg, oral contraceptives, systemic corticosteroids, etc.);
• subjects who have undergone kidney transplantation;
• people with a malignant tumor on an internal organ (a very rare cause of acanthosis nigricans, especially malignant ones).

Signs and symptoms

Skin changes are the only signs of acanthosis nigricans. Skin changes tend to develop slowly, sometimes over several months or years. If symptoms appear suddenly, you should consult a dermatologist immediately, as the lesions can be a danger signal for very serious conditions.

At the skin level, the following symptoms can be noted:

• dark spots, which can vary in color from gray to brown or black, are located near the folds of the body (see photo above);
• lesions look like “velvety” thickenings () compared to the surrounding skin;
• dark brown skin may form small ridges (papillomatosis);
• the affected area may also be aching or itchy.

The body folds most commonly affected by an attack of acanthosis include:

• sides and back of the neck;
• armpits;

Less commonly, skin lesions of acanthosis nigricans may also affect the following areas:

• face (front);
• inner thighs;
• elbows;
• knees;
• breast;
• navel or belly.

Very rarely, acanthosis nigricans can develop from:

• nipples;
• palms of hands;
• leg;
• centuries;
• lips;
• oral cavity.

Complications

Sometimes even a small change in the skin can represent an early warning sign for an underlying condition that requires treatment. For this reason, it is important to consult a dermatologist if you notice a darker or thicker area of ​​skin, especially if the changes appear suddenly.

People with acute acanthosis are more likely to develop: Skin damage can be a sign of prediabetes and for this reason, making some lifestyle changes can prevent the onset of the actual disease.

If acanthosis nigricans tends to spread and affect other less commonly affected areas such as the hands or lips, it should require immediate medical attention. Additionally, in these cases, the patient should be tested for types of malignancies that may be associated with the disease.

Diagnostics

The doctor will certainly try to determine what is causing the hyperpigmentation and thickening of the skin. Acanthosis nigricans is usually easily recognized when skin examination, so only in rare cases does a specialist decide to take a small skin sample ( biopsy) for histological verification. To identify acanthosis nigricans, your doctor may recommend blood tests, x-rays, or further testing to rule out other possible causes.

Treatment

In many situations, treatment of the underlying condition can restore normal skin pigmentation. Management of the benign form associated with obesity and insulin resistance conditions is based on reducing insulin levels in the circulation; Often a simple diet can significantly reverse skin damage.

Other underlying clinical conditions should be treated appropriately (as, for example, in the case of thyroid pathologies or adrenal disorders).

If the condition is caused by medications, your doctor may consider changing or changing your prescription for the medications that are causing the side effect.

Once the underlying medical condition has been diagnostically confirmed to improve the appearance of the skin, or if the lesions become itchy or irritating, a doctor may prescribe a topical cream or lotion.

Treatment for acanthosis nigricans includes the following:

• weight loss, changing eating habits and practicing regular exercise;
• application of drugs containing alpha hydroxy acids, such as glycolic or lactic acid;
• lotions containing salicylic acid;
• creams containing urea(often recommended in concentrations of 20%);
• cream cortisone(if the areas are itchy);
• retinoids, such as tretinoin (Retin-A), tazarotene or adapalene, to whiten the affected areas (they mainly perform an exfoliating action, renewing the more superficial layers of the dermis);
• antibacterial soaps or local antibiotics to reduce itching and discomfort.

None of these treatments are specifically designed to treat acanthosis sufferers, but they can all help alleviate the symptoms of the disorder.

Treatment for most resistant cases of acanthosis nigricans may include:

• fish fat food supplements included in the diet;
• isotretinoin, a potent drug commonly used in the treatment of scars and acne.

Some procedures for aesthetic treatment of acanthosis nigricans include:

• dermabrasion, a mechanical, controlled surgical scraping of the skin that can help reduce the consistency of some affected areas;
• laser therapy, which allows you to reduce the thickness of the skin (destroys the most superficial layers).

Maintaining a healthy lifestyle can prevent the disease from occurring in susceptible people and can also reduce the risk for many other types of diseases. Losing weight, dieting, and changing medications that trigger the disease are all important steps.

Acanthosis nigricans was first described in Germany in 1889. According to studies, it may have a certain relationship with malignant and benign tumors.

What is the disease

Acanthosis nigricans is a pigmentary papillary dystrophy of the skin. It is considered a dangerous disease, as it can be benign or malignant. The benign form occurs mainly in children and is associated with disruption of the endocrine system, especially if diseases such as obesity and diabetes are additionally observed. Dystrophy can also occur due to disorders of the nervous system.

The malignant form occurs already in adulthood. This disease is dangerous because it is accompanied by malignant neoplasms of internal organs and is observed mainly in places of greatest friction of the skin.

Causes

The causes of acanthosis nigricans are not precisely determined, but scientists have established a certain connection with predisposing factors. In particular, these factors include:

• heredity;
• disruption of the endocrine system;
• taking certain medications.

The disease can occur in a person at any age, and the main reasons for its formation also vary significantly among different age groups. In addition, consumption of fatty or starchy foods, as well as excess weight, may be triggering factors.

Main symptoms

Acanthosis nigricans of the papillary layer of skin is manifested mainly by the following symptoms:

• roughening and exfoliation of skin areas;
• increased pigmentation of affected skin areas;
• the appearance of papillomas and fibromas on the skin.

This disease mainly manifests itself in the natural folds of the skin. Very rarely, in a patient, changes in the skin become widespread and cover a significant area near the main lesion. In this case, changes can also be observed in nearby organs.

A photo of acanthosis nigricans clearly shows the peculiarity of the course of the disease. Initially, the patient develops an area of ​​a yellowish tint, which over time acquires a darker and more saturated color. Gradually, fibromas and papillomas begin to form on the affected area. The mucous membranes are predominantly not affected, but papillomas can also form on them. Sometimes a person may feel tingling and itching in the affected area.

If a malignant tumor is present, a person feels severe weakness, apathy, drowsiness, and also begins to lose a lot of weight.

Carrying out diagnostics

If acanthosis nigricans occurs in a person, then diagnosis in middle-aged and elderly patients is based on an external examination of the spots that appear. All patients with this disease should undergo a comprehensive evaluation to check for malignancy.

The doctor orders laboratory tests. Such disorders can be determined by performing an insulin resistance test, since often no signs of diabetes will appear, but the level of insulin in the blood will be very high. That is why, if there is a suspicion of the presence of a benign tumor, consultation with an endocrinologist is required. In addition, a biopsy may be prescribed followed by examination of the resulting tissue.

Treatment of the disease

There are no specific treatment methods for acanthosis nigricans. The main goal of therapy is to eliminate the underlying disease. Often, for the treatment of benign neoplasms, vitamin A, ascorbic acid, and salicylic ointment are prescribed, which must be applied to damaged areas of the skin. In the presence of hormonal disorders, hormonal therapy is prescribed.

Therapy using liquid nitrogen applications has been quite successful. During therapy, it is best if the patient is in a hospital. If malignant acanthosis nigricans occurs, the tumor is usually removed. However, it is worth remembering that the disease can recur with relapses and the presence of metastases.

Malignant acanthosis nigricans is quite common, and its treatment with Vetom brings very good results, since this drug helps reduce the effects of chemotherapy. In the presence of malignant neoplasms, this remedy is used to strengthen the immune system, as a restorative antitumor drug.

If there are warts on the skin, tissue coagulation is carried out under the influence of electric current. Special ointments or alcohol tinctures are applied to areas with increased skin pigmentation. It is imperative to strengthen the immune system, for which vitamin complexes are used, as well as echinacea and ginseng extracts. In addition, anti-inflammatory and antiseptic powders are used. Baths with the addition of potassium permanganate help a lot.

In severe cases of the disease, hormonal therapy is prescribed. Patients throughout their lives need to constantly take zinc supplements to help maintain a person’s good condition.

Prognosis of the course of the disease

Many patients with a benign form of the disease additionally have an insulin-resistant state, which becomes the main cause of acanthosis. The severity of the disease and the prognosis after treatment largely depend on the degree of insulin resistance. In the presence of an open form of diabetes, the prognosis is quite disappointing. With proper and timely treatment, a quick recovery can be achieved. The teenage form is characterized by the fact that the disease goes away on its own as the child grows older.

In the case of a malignant form of the disease, the prognosis is quite disappointing, since the main tumor is aggressive. The average life expectancy of such patients is 2 years, although there are cases where people lived for more than 10 years.

Carrying out prevention

To reduce the likelihood of the disease occurring, it is imperative to follow certain preventive measures. Such preventive measures include maintaining a normal body weight. In addition, it is imperative to monitor insulin levels and maintain them within normal limits.

Complications

Complications can be very different, depending on the characteristics of acanthosis nigricans. In children, the disease mainly occurs in a benign form, so the occurrence of dangerous complications is not observed.

In adults, the disease is more acute, and serious complications are observed when the disease becomes chronic. Seborrhea, fungal infections, as well as relapses and metastases of malignant tumors are often observed.

Acanthosis nigricans in dogs: characteristics and treatment

In animals, the disease is characterized by the appearance of many growths and papillomas in large folds of the skin. At the same time, the color of the skin changes and cell proliferation occurs.

Acanthosis nigricans in dogs occurs for a variety of reasons, including:

• endocrine disorders;
• malignant neoplasms;
• obesity;
• heredity.

The main signs of the disease are characterized by the appearance of keratinized areas of the skin and strong pigmentation. These areas are mainly concentrated between the buttocks, in the thigh and groin folds, armpits, near the navel, near the ears and on both sides of the neck.

The animal's skin acquires a brownish tint and becomes very dry, and after a while begins to darken. Many folds and growths appear, and the relief increases significantly. The primary form of the disease occurs in dachshunds of both sexes, mostly before one year of age. Secondary is observed in dogs of all breeds, but most often in smooth-haired dogs. This condition indicates problems with the adrenal cortex or thyroid gland.

Treatment of the primary form of the disease is currently ineffective, since there are no targeted drugs. The animal's condition can be alleviated only by taking hormonal medications and various topical creams.

The use of glucocorticoids and vitamin E is indicated. In the presence of a secondary form of the disease, therapy is not required, since the symptoms generally go away on their own. Only the use of products to eliminate skin inflammation is indicated.

Acanthosis nigricans (ICD-10 code L 83) is a type of dermatosis that is extremely rare. The disease is observed among fair-skinned people with a frequency of 1%, among dark-skinned people it occurs in 13.5%. The disease affects women more often than men.

Acanthosis nigricans has many different synonyms, such as papillary pigmentary dystrophy of the skin, papillary melasma, keratosis nigricans and genodermatosis. The first recorded case of this disease was described by doctors Wann and Pollitzer in 1889. And by 1909, the pathology was described in 50 cases. Scientists have concluded that the disease may be associated with malignant processes.

The disease is characterized by the appearance (coarsening) in areas of natural folds of the skin. Papillomas are localized in such places, and also noticed. Most often, the axillary folds, inguinal and cervical folds are affected. The disease must be treated comprehensively.

Etiology

The development of genodermatosis is influenced by various factors. To date, researchers have not been able to find the exact cause of the development of the disease, however, a reliable relationship has been established with the following factors:

• hereditary factor;
• malignant processes and neoplasms;
• changes in the functioning of the endocrine system;
• use of estrogen and glucocorticosteroid hormones;
• taking certain medications.

As for the hereditary factor, the disease can progress if the patient has congenital syndromes accompanied by metabolic dysfunction or mental disorders.

The tumor process provokes acanthosis nigricans with a list of biochemical reactions and immune interactions. The male sex predominantly suffers from, the female - from and. Papillary pigmentary dystrophy of the skin is also observed in the presence of other malignant tumors.

Pathology can provoke hormonal imbalance (cellulite). When nicotinic acid is consumed in large dosages, the development of the disease is also noted.

Classification

The following forms of acanthosis nigricans are distinguished:

• benign (juvenile);
• malignant;
• pseudoacanthosis.

The disease usually appears in a child due to a hereditary factor in a benign form. The first signs of acanthosis nigricans can be noticed in childhood, less often during puberty. The hereditary form is pronounced in childhood and partially fades in adulthood.

The disease can also be classified depending on the cause of its occurrence:

• hereditary (adolescent form) - occurs in childhood during puberty, often appears with various developmental defects - dementia, idiocy, infantilism;
• benign appearance - often noted in pathology of the endocrine glands, which is accompanied by diabetes mellitus with the use of insulin, a high amount of insulin is found in the blood, accompanied by polycystic ovary syndrome;
• false form - develops against the background of excess weight or in people living in a hot, humid climate; self-healing is possible when the cause of the disease is eliminated;
• dosage form of dermatosis - develops due to the ingestion of large quantities of insulin or nicotinic acid preparations into the body;
• malignant – more often observed in people over 40 years of age, provokes the development of malignant neoplasms of internal organs;
• acral - quite rare, located in places uncharacteristic for the disease.

The form of pathology is determined through diagnostic measures.

Symptoms

The clinical picture of a rare disease is characterized by the following symptoms:

• roughening of the skin;
• exfoliation of skin;
• the presence of black or brown spots on the skin;
• skin lesions with papillomas or fibromas.

The appearance of such skin defects is noted in the natural folds of the skin:

• axillary folds;
• fold between the neck and the back of the head;
• inguinal-femoral fold;
• intergluteal fold;
• elbow bend;
• area under the knee;
• fold under the mammary glands (in females).

There are cases when deformation of the skin is observed in other places on the human body (face, navel area).

Initially, acanthosis nigricans in humans is manifested by the appearance of an area with a yellowish tint to the skin, which becomes darker over time. As the disease progresses, the affected skin becomes dry and rough, acquiring a dark brown or black color. Defects on the skin increase in size, or small ones appear in their places, tightly touching each other.

The time of development of the disease directly depends on the form of the pathology. The malignant form of acanthosis nigricans will be more pronounced and develop much faster than the benign one.

Diagnostics

In order to correctly establish a diagnosis, a specialist must:

• conduct a thorough examination of the patient;
• study the clinical picture of the patient.

Additionally, the following tests may be prescribed to confirm the diagnosis:

• biopsy;
• blood analysis;
• X-ray examination.

It is also necessary to carry out differential diagnosis in order to be able to distinguish acanthosis nigricans from diseases such as:

• pseudoacanthosis nigricans;
• actinic keratosis;
• Darier's disease.

The clinician should not confuse the disease with exogenous keratosis, in which papillomas appear in places where they come into contact with an irritant.

Treatment

In the presence of keratosis nigricans, treatment should be developed in a comprehensive manner, and tactics are aimed at eliminating the root cause. Also, all patients must be constantly monitored at the dispensary.

If a benign form of keratosis nigra is diagnosed, then the following are prescribed:

• vitamin complexes (complex of vitamins A, B and C, medicines with ginseng and echinacea);
• ointments with anti-inflammatory and antiseptic effects;
• creams to soften and soothe the skin;
• medicines containing zinc;
• biological products;
• for disorders of the thyroid gland - hormonal drugs;
• neurotropic drugs (depending on the course of the disease);
• antibacterial drugs (depending on the course of the disease).

Treatment for acanthosis nigricans involves following a diet in cases where excess weight is a factor in the development of the disease.

If complications occur, cytostatics or aromatic retinoids may be prescribed. The malignant form requires treatment with radiotherapy, chemotherapy or surgery, which is the best option for solving the problem. After surgery and removal of the seal, the patient’s complete recovery is observed.

Prevention

Acanthosis nigricans requires the following preventive measures:

• regular examination by a dermatologist;
• maintaining proper nutrition;
• it is necessary to regularly monitor blood sugar levels;
• exclude self-medication.

The prognosis of the pathology primarily depends on its form. If with benign acanthosis nigricans and pseudoacanthosis the prognosis is predominantly favorable, up to the complete disappearance of characteristic symptoms, then the malignant form has negative consequences, since the neoplasms quickly metastasize.

A timely visit to a qualified specialist will help to quickly diagnose the disease and begin treatment, avoiding adverse consequences.

Is everything in the article correct from a medical point of view?

Answer only if you have proven medical knowledge

Acanthosis nigricans is a rare dermatosis characterized by roughening of the skin and the appearance of warty, black-brown growths on its surface. Skin lesions are observed mainly in large folds and on the skin of the neck. There are two forms of this disease - benign and malignant.

Reasons for development

Acanthosis nigricans is classified as a polyetiological disease, that is, many different reasons can lead to the development of this dermatosis.

The cause of acanthosis can be endocrine disorders, in particular insulin resistance. Acanthosis often develops in people who are overweight and.

Acanthosis nigricans can be provoked by various congenital syndromes, accompanied by mental inferiority, metabolic disorders, etc. Thus, acanthosis nigricans is often observed in Miescher and Rud syndrome.

The malignant form of acanthosis nigricans appears in older people; as a rule, in this case, dermatosis is a concomitant disease with cancerous tumors of internal organs.

Treatment by taking medications can trigger the development of manifestations of acanthosis. As a rule, these are hormonal drugs - corticosteroids, estrogens, etc. Much less often, acanthosis develops when taking non-hormonal drugs; there have been cases of the development of this dermatosis when taking nicotinic acid in large doses.

Clinical picture

The main symptoms of this dermatosis are thickening of the skin and the appearance of papillary growths on it. Sometimes observed in affected areas.

The lesions in acanthosis are usually located symmetrically. The main locations are the back of the neck, groin folds, knee or elbow folds, folds under the chest and armpits. Sometimes the mucous membranes of the mouth and genitals are affected.

The disease begins with the appearance of areas of slightly yellowish, gradually darkening skin. Areas of yellow skin are very often confused with. As acanthosis develops, the skin thickens, becomes moderately rough, and dry. The skin color in the affected areas becomes dark, even black. Often, at the first stage of the disease, patients complain that they cannot wash their blackened neck or armpits, since the skin in these places looks dirty.

With acanthosis, growths appear on the affected skin in the form of papillae protruding above the surface. The growths are arranged in dense rows, so the skin takes on a warty appearance.

In severe cases of the disease, papillary growths form in the lesions, which are similar in appearance to or large.

On the mucous membranes, pigmentary dystrophy with acanthosis nigricans is never observed, but growth may be present.

As a rule, there are no subjective symptoms with acanthosis. It is extremely rare for patients to complain of mild itching or tingling. There is no hair in the areas where the lesions are located. Some patients experience darkening of the nails as with and the appearance of longitudinal stripes and grooves on them, which are symptoms.

The severity of symptoms with acanthosis can vary. In the malignant form, the manifestations of the disease are usually more pronounced and develop much faster.

A malignant form of acanthosis is observed in adult patients. In approximately a fifth of patients, manifestations of acanthosis become an early symptom of oncology, appearing several years before the appearance of the first clinical symptoms of cancer. In 60% of patients, symptoms of acanthosis nigricans appear simultaneously with clinical manifestations of cancer. In the remaining 20% ​​of patients, acanthosis nigricans appears in the late stages of tumor growth, sometimes even during the period of its disintegration.

The benign form of acanthosis is called juvenile, since this type of dermatosis manifests itself in children or adolescents. The clinical manifestations of the disease are similar to the malignant form, the only difference being that the symptoms are less severe.

In a benign form of the disease, symptoms stabilize or regress over time.

Diagnostic methods

The basis for diagnosing acanthosis nigricans is an external examination and study of the clinical picture. If this disease is suspected, it is necessary to comprehensively examine the patient in order to identify possible causes that led to the appearance of dermatosis.

It is imperative that multiple examinations for cancer are carried out, since acanthosis detected in adults is often an early symptom of the development of malignant neoplasms of the gastrointestinal tract, lungs, uterus and other internal organs.

Removal of the tumor and further treatment of oncology, as a rule, leads to regression of skin manifestations. Recurrence of acanthosis nigricans often indicates the presence of metastases or the growth of a new tumor.

Patients with a benign form of acanthosis should be referred to an endocrinologist for a comprehensive examination. You will definitely need to be examined by a gastroenterologist to rule out pathologies of the gastrointestinal tract.

Treatment

Treatment of acanthosis nigricans is symptomatic, since this disease is most often a consequence of some pathology in the body that requires separate therapy.

Patients are prescribed reaferon intramuscularly, amiksin, neovir. The use of general strengthening agents is indicated - ascorbic acid, retinol, iron supplement, vitamin B group.

Local treatment is also used. Patients are prescribed the use of antiseptic, anti-inflammatory ointments and powders. General baths with the addition of KMnO4 are useful.

It is imperative to treat the underlying pathology. Depending on the identified pathologies, patients are prescribed hormone replacement therapy - insulin, estrogens, corticosteroids. By the way, insulin must be taken by those who are over . According to indications, antibacterial agents and neurotropic drugs may be prescribed.

In the presence of extensive growths on the skin, destructive therapy is used. The formations are removed by cryodestruction (liquid nitrogen) and electrocoagulation.

If the main reason for the development of acanthosis is the use of medications, it is necessary to stop taking them and select safer analogues. Obese patients are advised to follow a diet.

Prognosis and prevention

The prognosis for acanthosis nigricans depends on the form of dermatosis. If it is malignant acanthosis, the prognosis is poor. On average, after the first signs of skin manifestations of the disease appear, the life expectancy of patients is 2 years, despite the treatment undertaken.

In the benign form, the prognosis for acanthosis nigricans depends on the cause of the disease. When the hormonal or general condition is corrected, the symptoms of dermatosis disappear.

Prevention of the development of the disease consists of regular medical examinations. It is necessary to monitor your body weight and regularly monitor your blood glucose levels. If treatment with hormonal drugs is necessary, do not exceed the course duration and recommended doses.