Acanthosis nigricans: Difference between revisions
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==Background== | ==Background== | ||
*Multiple forms, but malignant acanthosis nigricans is most important | *Multiple forms, but malignant acanthosis nigricans is most important | ||
**Most commonly associated with [[colon cancer|colonic adenocarcinoma]], gastric cancer, ovarian cancer | |||
**Also associated with other dermal manifestations of internal cancers | |||
*Associated with GI and GU malignancies, which may have concomitant weight loss | *Associated with GI and GU malignancies, which may have concomitant weight loss | ||
*Non malignant form may be associated with endocrine abnormalities, such as insulin resistance | *Non malignant form may be associated with endocrine abnormalities, such as insulin resistance | ||
==Clinical Features== | ==Clinical Features== | ||
[[File:malignant_acanthosis_nigricans_ovarian.png|thumb|Malignant acanthosis nigricans secondary to ovarian cancer]] | |||
*Hyperpigmented, velvety | *Hyperpigmented, velvety | ||
*Plaques | *Plaques | ||
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*May have concurrent acrochordons, skin tags | *May have concurrent acrochordons, skin tags | ||
== | ==Differential Diagnosis== | ||
==Evaluation== | |||
===Diagnosis=== | |||
*Red flags: | *Red flags for ''malignant'' acanthosis nigricans: | ||
** | **Oral involvement (up to 50%) | ||
**Rapid appearance of lesions | **Rapid appearance of lesions | ||
**Extensive involvement | **Extensive involvement | ||
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**Unexplained weight loss | **Unexplained weight loss | ||
**Lesions in atypical sites such as palms/soles, mucous membranes | **Lesions in atypical sites such as palms/soles, mucous membranes | ||
==Management== | ==Management== | ||
Revision as of 20:42, 29 March 2023
Background
- Multiple forms, but malignant acanthosis nigricans is most important
- Most commonly associated with colonic adenocarcinoma, gastric cancer, ovarian cancer
- Also associated with other dermal manifestations of internal cancers
- Associated with GI and GU malignancies, which may have concomitant weight loss
- Non malignant form may be associated with endocrine abnormalities, such as insulin resistance
Clinical Features
- Hyperpigmented, velvety
- Plaques
- Most commonly intertriginous areas, posterior neck
- May have concurrent acrochordons, skin tags
Differential Diagnosis
Evaluation
Diagnosis
- Red flags for malignant acanthosis nigricans:
- Oral involvement (up to 50%)
- Rapid appearance of lesions
- Extensive involvement
- Older adult
- Unexplained weight loss
- Lesions in atypical sites such as palms/soles, mucous membranes
Management
Disposition
External Links
See Also
References
Schwarzenberger K, Callen JP. Chapter 53: Dermatologic manifestations in patients with systemic disease. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2017:820.