Cutaneous Manifestations of Type 2 Diabetes

Acanthosis Nigricans – Pathogenesis and Clinical Features

Acanthosis nigricans (AN) is a common dermatological condition associated with insulin resistance, often presenting as hyperpigmented, velvety plaques in body folds. Understanding its pathogenesis and clinical implications is crucial for early diagnosis and intervention.

Pathogenesis of Acanthosis Nigricans

The primary mechanism behind AN is the increased activity of insulin-like growth factor receptors due to hyperinsulinemia. This stimulates epidermal keratinocytes and fibroblasts, leading to dermal hyperplasia and pigmentation.

Clinical Features

• Appearance: Dark, thickened, velvety patches typically found in the axillae, neck, and groin.
• Associations: Frequently linked with metabolic syndrome, obesity, and endocrinopathies.
• Severity: Can range from mild cosmetic changes to extensive involvement, sometimes indicating malignancy.

Diagnosis and Management

Diagnosis is primarily clinical, supported by metabolic evaluations to assess insulin resistance. Management includes treating the underlying metabolic condition, weight reduction, and the use of topical retinoids or keratolytics.

Conclusion

Acanthosis nigricans serves as an important cutaneous marker for systemic diseases, particularly Type 2 diabetes. Early recognition aids in timely intervention and risk mitigation.