Acanthosis nigricans: Difference between revisions
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==Background== | ==Background== | ||
{{Skin anatomy background images}} | {{Skin anatomy background images}} | ||
*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 | **Most commonly associated with [[colon cancer|colonic adenocarcinoma]], gastric cancer, ovarian cancer | ||
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*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 | ||
{{Primary derm lesions names}} | |||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 16:12, 11 December 2024
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
Dermatology Nomenclature
Small lesions (<0.5cm)
| Name | Raised/Palpable | Fluid-Filled | Other Description | Diagram |
| Macule | No | None | flat, cirumscribed, colored | 
|
| Papule | Yes | None | Solid | 
|
| Vesicle | Yes | Clear | .png)
| |
| Pustule | Yes | Pus | Leukocytes or keratin | 
|
Large lesions (>0.5cm)
| Name | Raised/Palpable | Fluid-Filled | Other Description | Diagram |
| Patch | No | None | Large macule (flat, colored) | 
|
| Plaque | Yes | None | Superficially raised, circumscribed solid area | 
|
| Nodule | Yes | None | Distinct large papule | 
|
| Bulla | Yes | Clear | Large vesicle/blister or exposed epidermal layer | 
|
| Wheal | Yes | Edema | Firm and edema of dermis |
Other
- Eschar
- Fissure/erosion/ulcer
- Necrotizing rashes
Clinical Features
- Hyperpigmented, velvety
- Plaques
- Most commonly intertriginous areas, posterior neck
- May have concurrent acrochordons, skin tags
Differential Diagnosis
Dark raised skin lesions
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.