Acanthosis Nigricans: A Skin Marker of Cancer
Acanthosis nigricans is the cry of the skin for attention! It is a skin disorder characterised by thickening, pigmentation and a fine or rough velvety appearance, particularly over body folds. It can be caused by a variety of causes.
People with acanthosis nigricans are known for their resistance to insulin in diabetics.
According to the causes, acanthosis nigricans is divided into two major types, the Benign and the more serious, malignant variety. Thus acanthosis nigricans may be the first sign of an underlying malignany and calls for a thorough physical and blood check up and other investigations including scans.
People with acanthosis nigricans are known for their resistance to insulin in diabetics.
According to the causes, acanthosis nigricans is divided into two major types, the Benign and the more serious, malignant variety. Thus acanthosis nigricans may be the first sign of an underlying malignany and calls for a thorough physical and blood check up and other investigations including scans.
Types of Acanthosis Nigricans
It is important to differentiate the benign from malignant as early diagnosis can be life saving.
A. BENIGN ACANTHOSIS NIGRICANS
Hereditary benign acanthosis nigricans: This runs in
families, but does not usually show any evidence of endocrinological
disturbances or internal malignancy.
Endocrinal acanthosis nigricans: It is associated with many
endocrine problems like acromegaly, addison's disease, Cushing's
diseases, insulin resistant diabetes mellitus, hypothyroidism,
ovarian hyperthecosis, hepatic cirrhosis,Wilson's disease etc
Pseudo acanthosis nigricans: This is a reversible type and
usually starts in puberty. It commonly affects dark skinned people
and is associated with obesity
Drug induced acanthosis nigricans: Nicotinic acid is notorius
in causing acanthosis nigricans. Other drugs like stilbostreol,
corticosteroids, oral contraceptive pills etc can also cause
acanthosis nigricans like lesions.
B. MALIGNANT ACANTHOSIS NIGRICANS
Internal malignancies (cancers), especially the adenocarcinomas
affecting the stomach, lungs etc can cause acanthosis nigricans.
Sometimes lymphoma may be the culprit.
Hereditary benign acanthosis nigricans: This runs in
families, but does not usually show any evidence of endocrinological
disturbances or internal malignancy.
Endocrinal acanthosis nigricans: It is associated with many
endocrine problems like acromegaly, addison's disease, Cushing's
diseases, insulin resistant diabetes mellitus, hypothyroidism,
ovarian hyperthecosis, hepatic cirrhosis,Wilson's disease etc
Pseudo acanthosis nigricans: This is a reversible type and
usually starts in puberty. It commonly affects dark skinned people
and is associated with obesity
Drug induced acanthosis nigricans: Nicotinic acid is notorius
in causing acanthosis nigricans. Other drugs like stilbostreol,
corticosteroids, oral contraceptive pills etc can also cause
acanthosis nigricans like lesions.
B. MALIGNANT ACANTHOSIS NIGRICANS
Internal malignancies (cancers), especially the adenocarcinomas
affecting the stomach, lungs etc can cause acanthosis nigricans.
Sometimes lymphoma may be the culprit.
Learn More About Acanthosis Nigrican and Skin Cancers
Curth's criteria for cancer-related dermatoses.(Clinical Rounds): An article from: Skin & Allergy News
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Avoiding Cancer One Day At A Time: Practical Advice For Preventing Cancer
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100 Questions & Answers about Melanoma & Other Skin Cancers
Amazon Price: $16.15 (as of 07/13/2009)
Cancer of the Skin: Text with CD-ROM
Amazon Price: $189.05 (as of 07/13/2009)
Atlas of Cancer of the Skin (Sams/Lynch colour atlas)
Amazon Price: $204.00 (as of 07/13/2009)
How to Differentiate the Benign from Malignant Acanthosis Nigricans
Differentiating is essential for early diagnosis of internal malignancies
Do's and Dont's of Acanthosis Nigricans
Special Stress on Do's
Do's:
- Differentiate between benign and malignant with the help of
a dermatologist - Reduce body weight
- Strict control of diabetes if already diagnosed
- Regular aerobic exercises
- Full investigations including tumor markers, hormonal assay,
ultra sound scan, MRI etc - Regular medical check up, semi annual
- Report any sudden changes in morphology , i.e, color,
margins, spread, texture etc.
Don'ts
- Scrub too much, as frequent rubbing will only increase skin
thickening and pigmentation - Use strong abrasives: tend to irritate the skin more.
When to Consult Your Dermatologist
Something that every Acanthosis Nigricans Patient should know
Consult Dermatologist when the characteristics of acanthosis nigricans are as in the malignant column above.
Salient Features of an internal cancer presence are:
Salient Features of an internal cancer presence are:
- Late onset
- Rapid progression
- Severe affection
- Extensive distribution
- Mucous membrane involvement
- More symptoms like irritation and sudden appearance of skin tags
Treatment Guidelines for Acanthosis Nigricans
Under The Guidance of a Dermatologist Only
- Correction of underlying cause
Removal of tumor
Correction of endocrine disorder
Reduction of weight
Removal of causative drug - Dietary supplimentation with fish oil containing omega 3 fatty acids
have been reported to be beneficial - Cyproheptadine has been found useful in some cases
- Management of Skin Lesions:
Topical Retin A
Salicylic acid application alone or in combination with steroids,
alternating with emollient applications to minimize irritation.
In severe unresponsive cases, systemic retinoids may be given a trial
under the guidance of a dermatologist.
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by drhanish
I am Dr.Hanish Babu, MD, author and CEO, Lesstress.net, Dermato- Venereologist, Stress Management Trainer and an Internet Entrepreneur.
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