Acanthosis nigricans is one of the pigment disorders. This results in gray to dirty brown skin growths.
What is acanthosis nigricans?
Acanthosis nigricans is a pigment disorder of the skin. She will too Black growth skin called. A typical feature of the disease is the dirty brown or gray growths that form on the skin. The armpits, elbows, neck and back of the knees are particularly affected. Sometimes the changes can also be seen in the lumbar region as well as the soles of the feet, palms and lips.
Acanthosis nigricans is considered to be an indication of serious health problems. This primarily includes prediabetes. The pigment disorder can occur in both men and women. It is most common in overweight people with darker skin. Native Americans are primarily affected, with a share of around 34 percent. However, the risk of disease is considered to be the same for all ethnic groups with a significantly higher body mass index (BMI).
causes
The typical skin spots of acanthosis nigricans are caused by the rapid multiplication of epidermal cells. The cause of this pathological skin cell growth is usually a rising insulin level in the blood. In some people, the use of certain drugs or cancer also causes the skin changes.
In most cases nigricans acanthosis is caused by an excess of insulin in the blood. When eating, carbohydrates are converted into sugar molecules such as glucose. While part of the glucose is used by the body for energy consumption, the rest serves as a reserve. To use glucose for energy, insulin is required. So glucose can get into the body cells with the help of insulin. However, if you are overweight, insulin resistance will develop over the years.
The body is then no longer able to consume it normally, which in turn causes the glucose to build up in the bloodstream. This results in increased insulin and blood glucose levels. Due to the excess insulin, the skin cells multiply. People who are dark skin tone have plenty of melanin in their cells. As the melanin increases, the skin spots that develop are darker in color than the adjacent areas of skin.
For this reason, Acanthosis nigricans is an indication of diabetes mellitus (diabetes). However, certain drugs can also be used to trigger black growth skin. These can be growth hormones, the birth control pill, supplementary preparations for building muscles or thyroid drugs. All preparations have an effect on insulin levels.
Other possible causes, which are rare, however, are disorders of the adrenal cortex such as Addison's disease, low thyroid hormone levels, disorders of the pituitary gland, ingestion of high levels of niacin, and stomach cancer.
Diseases with this symptom
- Insulin resistance
- cancer
- Stomach cancer
- Pituitary adenoma
- Drug allergy
- Diabetes_mellitus
- Hypothyroidism
- Anterior pituitary insufficiency
- Adrenal insufficiency
- Pituitary Insufficiency
- high blood pressure
- Pituitary tumor
- Posterior pituitary insufficiency
Diagnosis & course
For most people, the dark patches of skin appear symmetrically in the armpit and groin area. In some cases they also appear on the hands and lips. A typical sign is a light brown or gray-black discoloration of the skin, which then looks "dirty".
The surface relief, which feels like velvet, is initially a papillous-hyperkeratotic coarsening. If acanthosis nigricans lasts for a long time, the skin looks increasingly rougher. Usually there are no other complaints.
An experienced doctor can usually diagnose acanthosis nigricans with the naked eye. A test for insulin resistance or diabetes mellitus as a possible root cause is important. A fasting insulin test or a blood glucose test can be done for this purpose.
In acanthosis nigricans, there is also a difference between a benign form (Acanthosis nigricans benigna) and a malignant form (Acanthosis nigricans maligna) differentiated. In order to differentiate between the two types, the search for a primary tumor is carried out. The carcinoembryonic antigen (CEA) and alpha-1-fetoprotein are determined in a laboratory. All of the patient's medications should also be checked to see if they are affecting the pigmentation disorder.Complications are primarily to be feared with malignant acanthosis nigricans, which occurs particularly in the elderly. The malignant form has a more pronounced disturbance than the benign form. The mean survival time for malignant acanthosis nigricans is two years. In the benign form, on the other hand, therapy of the underlying disease that triggers it is sufficient.
Complications
Acanthosis nigricans can be the cause of various complications. The skin disease initially leads to a change in the appearance of the skin, which is often associated with itching and pain in the groin and armpits. The neck, lips and hands can also be affected and turn gray-black as the disease progresses. Complications arise here mainly from the coarsening of the skin surface, which sometimes severely restricts the feeling in the affected regions and makes the skin more sensitive overall.
Acanthosis nigricans can develop into a malignant tumor disease, which is associated with carcinoma of the stomach and strong, usually painful pigmentation of the arms and legs. The consequences of these malignant forms of acanthosis range from itching and gastrointestinal complaints to extensive organ damage. Further complications depend on the cause of the acanthosis nigricans. If the complaints are based on obesity, diabetes mellitus or some other endocrinopathy, the typical sequelae occur: high blood pressure, overweight and other disorders of lipid metabolism.
The blood sugar level is also increased and so often causes a deterioration in the state of health. If acanthosis nigricans occurs as a dominantly inherited acanthosis nigricans benigna, the complications are less severe. After the disease, which often improves after puberty, only minor skin changes remain, while long-term complications usually do not occur.
When should you go to the doctor?
Acanthosis nigricans is a pigment disorder of the skin. The symptom is particularly evident under the armpits, elbows, neck and back of the knees. The soles of the feet, palms of the hands, lips and loins are less commonly affected. Acanthosis nigricans occurs primarily in connection with diabetes mellitus, and is preferred in overweight people with darker skin tones. Acanthosis nigricans is not just about discoloration of the skin, but rather a rapid increase in epidermal skin cells.
Acanthosis nigricans is almost always caused by an increased insulin level in the blood due to insulin resistance. The increased insulin leads to the multiplication of skin cells. In addition to diabetes mellitus, acanthosis nigricans is triggered by various drugs, such as birth control pills, thyroid drugs, growth hormones and muscle building supplements. In Acanthosis nigricans, hypothyroidism, pituitary disorders, Addison's disease and stomach cancer should also be considered.
Acanthosis nigricans exists in benign and malignant forms. Since the malignant form has a short survival time of around two years, a doctor should be consulted immediately if acanthosis nigricans occurs. Benign acanthosis nigricans can also turn into a malignant tumor disease. In addition to the general practitioner, specialists such as internists, dermatologists and oncologists can also treat acanthosis nigricans.
Doctors & therapists in your area
Treatment & Therapy
Acanthosis nigricans is not an independent disease. Rather, it is a symptom of another disease. Because of this, treatment for the pigment disorder focuses on the underlying cause. If the patient suffers from obesity, the doctor recommends that he reduce it. It is not uncommon for the sick person to receive drugs that can be used to normalize their blood sugar level.
If drugs or food supplements are the originators of acanthosis nigricans, they are usually discontinued or replaced by other means. In most patients, the dark patches of skin fade after successfully treating the root cause. If the skin changes lead to severe aesthetic impairments, cosmetic treatments can also be useful.
So the unsightly stains can be covered with special cosmetics. Treatment with prescription skin lighteners is also possible. Although these measures are less effective than treating the root cause, they at least provide relief.
Outlook & forecast
Acanthosis nigricans is in the majority of cases benign. However, this pigment disorder is always only a symptom of an underlying disorder. Therefore, the skin changes only improve if the cause is also eliminated.
In many cases, there is insulin resistance, which means that the pancreas makes more insulin. The increased insulin concentration causes an increased formation of receptors in the skin cells, which in turn lead to the noticeable skin pigmentation of acanthosis nigricans. If left untreated, insulin resistance can lead to type II diabetes mellitus.
As a rule, the skin changes are only an accompanying symptom that indicates the risk of diabetes.If insulin resistance can be reversed through weight loss, diet changes, and physical activity, skin pigmentation will also fade.
If there is an insulioma in the pancreas, surgery must be performed. Although it is a benign tumor, it causes constant food cravings, dizziness, impaired consciousness, sweating and weight gain. This can damage the central nervous system. In addition to these symptoms, acanthosis nigricans also disappears after surgery.
Those skin changes that are caused by the influence of medication usually improve even after the medication that caused them is discontinued. In rare cases, however, a malignant form of acanthosis nigricans can develop, which is mostly associated with malignant stomach tumors.
prevention
To prevent acanthosis nigricans, a healthy lifestyle is recommended. This includes a low-fat diet, regular exercise and reducing excess weight.
You can do that yourself
If there is acanthosis nigricans, there are some measures that the patient can carry out himself to get rid of the unsightly pigment disorders of the skin or at least to alleviate them. As the cause of the skin discoloration is usually an increased insulin level, everything should be done to reduce it. An increased insulin level is often found in people who are overweight, insulin resistant or type II diabetes mellitus. It can be reduced through weight reduction, plenty of exercise and a balanced diet. At the same time, the dark pigment spots usually fade.
However, if these measures do not help, it should also be checked whether it could be due to drugs or additional preparations for building muscle. The drugs that can be considered include growth hormones, the pill or thyroid preparations. Some preparations, such as the muscle building preparations, could be discontinued by the patient himself. In most other cases, however, the doctor should be consulted.
If no action is taken, there may be serious underlying conditions that only a doctor can treat. These include tumors in the pancreas (insuloma) which continuously produce insulin, malignant tumors in the stomach or hormonal disorders. By treating the underlying disease, the pigment disorder also disappears.
In the case of a lengthy treatment, the unsightly spots can also be covered beforehand by cosmetic measures or lightened by freely available skin lighteners that contain urea, retin-A, salicylic acid and alpha-hydroxylic acids.
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