Acanthosis Nigricans: How to Manage

 

Treatment of acanthosis nigricans involves topical treatment and removal of the offending cause of the skin thickening and pigmentation.

Treatment of Acanthosis Nigricans: Treating the Cause
Treatment of Acanthosis nigricans involves treating the Cause

Tips on Dealing with Acanthosis Nigricans

There are certain do’s and don’ts in dealing with acanthosis nigricans. These are important in limiting the spread of the disease and finding the underlying causes.

Do’s in dealing with acanthosis nigricans:

  • The first course open to a patient is of course differentiating the benign and malignant varieties of acanthosis nigricans, preferably with the help of a dermatologist.
  • Diet control and regular exercise to reduce weight is essential in controlling acanthosis nigricans
  • Diabetes, if present, should be brought under strict control through dietary restriction, exercises and effective medications
  • In case of suspected malignant acanthosis nigricans, full panel of laboratory investigations should be carried out without much delay. Tumor markers, hormonal assays, endoscopy, Ultrasound and CT scans and whole body MRI are mandatory in such cases. The appearance of acanthosis nigricans can precede the full expression of cancer even by 5 years.
  • Consultations with a general physician and a gastro-enterologist once in six months is advisable in suspected acanthosis nigricans where no primary focus could be found in previous check ups. The frequency should be increased in cases where the skin changes are rapidly progressing.
  • Any sudden progression of the skin condition, appearance of skin tags or seborrheic keratosis (Leser Trelat sign) calls for urgent medical consultation.

 

Acanthosis nigricans treatments depends upon finding and treating the basic cause

Don’ts in Dealing with Acanthosis Nigricans

There are certain things to be avoided in the presence of acanthosis nigricans:

Most people think that the dirty appearance of the skin in acanthosis nigricans is due to dirt deposition on the skin. This results in constant vigorous scrubbing of the involved skin. This should be avoided at all cost.

So, Don’t

  • Scrub too much, as frequent rubbing will only increase skin thickening and pigmentation
  • Use strong abrasives: tend to irritate the skin more.

Treatment Guidelines for  Acanthosis Nigricans

  1. Correction of underlying cause
  • Removal of tumor
  • Correction of endocrine disorder: In case of Insulin Resistance, Metformin could be useful in treating Acanthosis Nigricans, alone or in combination with Rosiglitazone.
  • Reduction of weight: Low carb diets and exercise will help.
  • 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

 2. Management of Skin Lesions:

  • Topical Retin A
  • Salicylic acid application alone or in combination with steroids, alternating with emollient applications to minimize irritation.
  • Calcipotriol
  • In severe unresponsive cases, systemic retinoids are useful.
  • TCA Peels, laser ablation all have been tried with varying results

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Published by Dr Hanish Babu, MD on 29th May, 2018

Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or the website will not be responsible for any consequences. The images provided are for illustration purpose only and are copyrighted.

Copyright 2018 © Dr Hanish Babu, MD

 

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