Acanthosis nigricans=ءاد ﻚاوﺸﻠا ﺪوﺴأﻠا

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12 Acanthos Nigricans EPIDEMIOLOGY Acanthos a200 probably most readily recognized manifestation percent diabetes. anthos Ac restance. idiopathic common some general cases, population, creased rogen most cases production are lked (5 also to identified. obesity Drug-related sul familial acanthos have been repted. general, though, should population-based be considered study prognostic from Galveston, dicat Texas, f developg type 2 diabetes. a66 large, was children crelated present who weighed 7 percent presence percent school-age severity ir children. ideal body Th fdgs. weight. percentage The rate th creased study, fastg to sul levels acanthos varies prevalence American creased among children sensitivity was different lower (13 percent). ethnic whites groups. (0.5 to Th fdg Galveston suggests Hpanics a study, possible despite percent) genetic similar than predposition obesity African rates, hypersulemia among certa populations. Although htical data have emphasized relationship between fdgs malignancy, are flid, apathogenesis true association non-obese percent) rare. non-diabetic Only when adult onset particularly rapid, clical auth's an evaluation experience f malignancy seeg beyond me than route 12,000 age patients appropriate screeng cancer, only warranted two developed. one acanthos. ETIOLOGY AND Advances are takg place understg pathogenes acanthos 21. plays a central role presentation sul 16.clearly a subset women hyperrogenm sul restance acanthos,upregulated found loss (type function A mutations type Bsul syndrome). sul recept basal anti-sul recept antibodies be It states postulated that excess growth fact stimulation causes aberrant can proliferation keratocytes fibroblasts results phenotype fact. sul restance hypersulemia,acanthos may result from excess bdg to IGF-1 recepts on fibroblasts. IGF-1 recepts expressed on keratocytes are proliferative conditions. through IGF-1 Studies recepts show that vitro. high Or concentrations members sul tyrose stimulate kase recept recept, family, have been cludg implicated epidermal are growth recept fibroblast fibroblastproliferation growth fact acanthos. Several genetic syndromes [growth Crouzon SADDAN (severe achondroplasia 22 developmental delay )] mutations fibroblast fact recept 3 result acanthos absence hypersulemia obesity. Implicatg th growth fact recept pathogenes. several repts 21 associated tum cells may malignancy, stimulate evidence suggests that transfmg growth fact-β released keratocyte proliferation facts via pathogenes epidermal growth fact recepts.suppt f role different growth acanthos contues toto accrue. addition direct effects imptance hypersulemia ondoes keratocytes, augment rogens rogen ovarian levels hypertrophy women. Highto cystic sul changes. levels stimulate sul production also appears ovariantrom Although associated elevated rogen levels, acanthos women polycystic ovarian syndrome (PCOS) not respond reliably to rapy, implicatg relative hypersulemia over hyperrogenm.antirogen Several drugs have also been repted cause acanthos cludg systemic glucocticoids,acrochdons nicotic acid, estrogens such as diethylstilbestrol. CLINICAL FINDINGS: CUTANEOUS LESIONS Clically, acanthos presents as brown to gray-black papillomatous cutaneous thickeng knuckles flexural areas, cludg posterolateral neck, axillae gro, texture. abdomal severely some folds. cases, The al, dtribution esophageal, however, usually pharyngeal, symmetric. laryngeal, The affected has dirty, conjunctival,velvety anogenital mucosal constently surfaces be affected volved. general, The development back superimposed neck back most hs volved over areas may well described even. on particularly palms can flid beusually cases, seen. When volvement palms on are volved, anigric rugated appearance palmar surface has been called tripe palms associated acanthos ans seen basal settg malignancy. area. majity cases, most imptant fact acanthos recognizg usually associated hypersulemia,diagnosg which ato known rk fact f type 2 diabetes. The htopathology clical lesions demonstrates papillomatos mimal hyperkeratos but acanthos. gmentation Hyperpi attributed layer has been variably by most. demonstrated brown col lesions retoids TREATMENT Treatment acanthos calcipotriol,salicylic acid, urea, systemic generally topical effective. Topical treatment have cause allmay Medications be used beneficial. that anecdotal Improvement improve success. sul sensitivity, resolution When identifiable, does such as treatment weight loss underlyg some obese metfm,patients. have. a etic benefit. Removal fendg medication generally results clearance patients acanthos underlyg gastric, made. association been When seen malignancy. chemapy ithyperkeratos malignancy, associated majity The re fdg cases. remits malignancy, an usually It may has present recurrences been improvement a tum repeatedly befe occur tra-abdomal followg after described treatment diagnos that ig, patients' usually malignancy.improves 12 / 12