by Kohnle D

Definition

Acanthosis nigricans is a skin condition in which brown or black velvet-like markings appear under the arms, in the groin, or on the back of the neck. Any skin fold can be affected, including the lower lip and chin.

Causes

Causes of acanthosis nigricans may include:

  • High insulin levels in people who are obese
  • A family history of acanthosis nigricans
  • A cancerous tumor—rare

Risk Factors

Acanthosis nigricans is more common in people of African-American decent. Other factors that may increase your chance of acanthosis nigricans include:

Symptoms

Symptoms include velvety-looking, dark areas anywhere on the skin.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Tests may include:

  • Blood tests
  • Skin biopsy if your doctor is concerned about skin cancer

Your bodily structures may need to be viewed. This can be done with:

  • X-rays
  • Endoscopy and colonoscopy —might be considered to screen for a rare malignancy associated with acanthosis nigricans if you are not obese or do not have diabetes
Endoscopy
Endoscope in stomach
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Treatment

Treatment often involves treating the underlying cause. For example, if acanthosis nigricans is due to obesity, weight loss can improve the skin condition.

Topical and oral retinoids and other medications have been reported to improve appearance in some cases. They help remove excess layers of skin.

Prevention

To reduce your chances of acanthosis nigricans:

  • Maintain a healthy weight
  • Eat a balanced diet
  • Get regular exercise most days of the week
  • Talk to your doctor about your blood sugar levels

RESOURCES

American Academy of Dermatology  http://www.aad.org 

NORD—National Organization for Rare Diseases  http://www.rarediseases.org 

CANADIAN RESOURCES

Canadian Dermatology Association  http://www.dermatology.ca 

Health Canada  hhttps://www.canada.ca/en/health-canada.html 

References

Acanthosis nigricans. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T113712/Acanthosis-nigricans  . Updated July 11, 2014. Accessed September 1, 2017.

Clark N, Stulberg DL, Tovey D. Common hyperpigmentation disorders in adults: part II. Melanoma, seborrheic keratoses, acanthosis nigricans, melasma, diabetic dermopathy, tinea versicolor, and postinflammatory hyperpigmentation. Am Fam Physician. 2003;68(10):1963-1968.

Katz AS, Goff DC, Feldman SR. Acanthosis nigricans in obese patients: presentations and implications for prevention of atherosclerotis vascular disease. Dermatol Online J. 2000;6(1):1.

Kong AS, Williams RL, Rhyne R, et al. Acanthosis Nigricans: high prevalence and association with diabetes in a practice-based research network consortium—a PRImary care Multi-Ethnic network (PRIME Net) study. J Am Board Fam Med. 2010;23(4):476-485.

Luba MC, Bangs SA, Mohler AM, Stulberg DL. Common benign skin tumors. Am Fam Physician. 2003;67(4):729-738.

10/15/2010 DynaMed Plus Systematic Literature Surveillance  https://www.dynamed.com/topics/dmp~AN~T113712/Acanthosis-nigricans  : Kong AS, Williams RL, Smith M, et al. Acanthosis nigricans and diabetes risk factors: prevalence in young persons seen in southwestern US primary care practices. Ann Fam Med. 2007;5(3):202-208.

Revision Information

  • Reviewer: EBSCO Medical Review Board James Cornell, MD
  • Review Date: 05/2018
  • Update Date: 09/02/2015