A comprehensive review of present therapies of acanthosis nigricans
Acanthosis nigricans treatments
DOI:
https://doi.org/10.22122/cdj.v12i3.886Keywords:
Acanthosis nigricans, insulin resistance, Diabetes MellitusAbstract
BACKGROUND: Acanthosis nigricans (AN), marked by velvety skin plaques, signifies an underlying systemic disorder linked to rising obesity and diabetes rates. This study explores a comprehensive investigation of current AN treatment options, aiding clinicians in choosing effective and appropriate interventions for patients.
METHODS: A literature review was conducted using databases such as Google Scholar, PubMed, and MEDLINE, focusing on AN treatments in the last decade and totally 32 articles were evaluated.
RESULTS: Topical treatments, including retinoids, vitamin D analogs, keratolytics, and peels, are explored. Topical retinoids, especially tretinoin and adapalene, have demonstrated efficacy in clinical studies, while vitamin D analogs like calcipotriol show promise. Systemic treatments, such as oral retinoids (isotretinoin, acitretin, etretinate), insulin sensitizers (metformin, rosiglitazone), and other oral medications, are discussed. Metformin stands out for its effectiveness in treating AN associated with insulin resistance (IR). Cosmetic lasers, including alexandrite and carbon dioxide (CO2) lasers, offer successful outcomes in treating AN although cost and availability can be limiting factors. Other treatments, such as podophyllin, fish oil, photochemotherapy (PUVA), and surgery, are also considered.
CONCLUSION: AN necessitates a multifaceted approach, targeting both underlying systemic disorders and cosmetic concerns. The findings underscore the significance of topical treatments, systemic therapies like metformin, and the promising role of cosmetic lasers in AN management. Despite limitations in available studies, this comprehensive overview provides valuable insights for healthcare providers, emphasizing the need for personalized treatment strategies. As the prevalence of AN rises globally, continued research and clinical exploration are essential to refine and expand treatment options for this dermatological condition.
References
Higgins SP, Freemark M, Prose NS. Acanthosis nigricans: A practical approach to evaluation and management. Dermatol Online J. 2008; 14(9): 2.
Hermanns-Le T, Scheen A, Pierard GE. Acanthosis nigricans associated with insulin resistance : pathophysiology and management. Am J Clin Dermatol. 2004; 5(3): 199-203.
Rendon MI, Cruz PD, Jr., Sontheimer RD, Bergstresser PR. Acanthosis nigricans: A cutaneous marker of tissue resistance to insulin. J Am Acad Dermatol. 1989; 21(3 Pt 1): 461-9.
Miura N, Ikezaki A, Iwama S, Matsuoka H, Ito K, Sugihara S. Genetic factors and clinical significance of acanthosis nigricans in obese Japanese children and adolescents. Acta Paediatr. 2006; 95(2): 170-5.
Phiske MM. An approach to acanthosis nigricans. Indian Dermatol Online J. 2014; 5(3): 239-49.
Kutlubay Z, Engin B, Bairamov O, Tuzun Y. Acanthosis nigricans: A fold (intertriginous) dermatosis. Clin Dermatol. 2015; 33(4): 466-70.
Das A, Datta D, Kassir M, Wollina U, Galadari H, Lotti T, et al. Acanthosis nigricans: A review. J Cosmet Dermatol. 2020; 19(8): 1857-65.
Popa ML, Popa AC, Tanase C, Gheorghisan-Galateanu AA. Acanthosis nigricans: To be or not to be afraid. Oncol Lett. 2019; 17(5): 4133-8.
Puri N. A study of pathogenesis of acanthosis nigricans and its clinical implications. Indian J Dermatol. 2011; 56(6): 678-83.
Patel NU, Roach C, Alinia H, Huang WW, Feldman SR. Current treatment options for acanthosis nigricans. Clin Cosmet Investig Dermatol. 2018; 11: 407-13.
Lahiri K, Malakar S. Topical tretinoin in acanthosis nigricans. Indian J Dermatol Venereol Leprol. 1996; 62(3): 159-61.
Berger BJ, Gross PR. Another use for tretinoin--pseudoacanthosis nigricans. Arch Dermatol. 1973; 108(1): 133-4.
Darmstadt GL, Yokel BK, Horn TD. Treatment of acanthosis nigricans with tretinoin. Arch Dermatol. 1991; 127(8): 1139-40.
Schwartz RA. Efficacy of topical 0.1% adapalene gel for use in the treatment of childhood acanthosis nigricans: A pilot study. Dermatol Ther. 2015; 28(4): 266.
Treesirichod A, Chaithirayanon S, Wongjitrat N, Wattanapan P. The efficacy of topical 0.1% adapalene gel for use in the treatment of childhood acanthosis nigricans: a pilot study. Indian J Dermatol. 2015; 60(1): 103.
Treesirichod A, Chaithirayanon S, Wongjitrat N. Comparison of the efficacy and safety of 0.1% adapalene gel and 0.025% tretinoin cream in the treatment of childhood acanthosis nigricans. Pediatr Dermatol. 2019; 36(3): 330-4.
Treesirichod A, Chaithirayanon S, Chaikul T, Chansakulporn S. The randomized trials of 10% urea cream and 0.025% tretinoin cream in the treatment of acanthosis nigricans. J Dermatolog Treat. 2021; 32(7): 837-42.
Weisshaar E, Bonnekoh B, Franke I, Gollnick H. Successful symptomatic tazarotene treatment of juvenile acanthosis nigricans of the familial obesity-associated type in insulin resistance. Hautarzt. 2001; 52(6): 499-503.
Blobstein SH. Topical therapy with tretinoin and ammonium lactate for acanthosis nigricans associated with obesity. Cutis. 2003; 71(1): 33-4.
Adigun CG, Pandya AG. Improvement of idiopathic acanthosis nigricans with a triple combination depigmenting cream. J Eur Acad Dermatol Venereol. 2009; 23(4): 486-7.
Binderup L, Bramm E. Effects of a novel vitamin D analogue MC903 on cell proliferation and differentiation in vitro and on calcium metabolism in vivo. Biochem Pharmacol. 1988; 37(5): 889-95.
Romo A, Benavides S. Treatment options in insulin resistance obesity-related acanthosis nigricans. Ann Pharmacother. 2008; 42(7): 1090-4.
Bohm M, Luger TA, Metze D. Treatment of mixed-type acanthosis nigricans with topical calcipotriol. Br J Dermatol. 1998; 139(5): 932-4.
Lee HW, Chang SE, Lee MW, Choi JH, Moon KC, Koh JK. Hyperkeratosis of the nipple associated with acanthosis nigricans: treatment with topical calcipotriol. J Am Acad Dermatol. 2005; 52(3 Pt 1): 529-30.
Reyes-Meza SE, Guevara-Gutierrez E, Villanueva-Quintero G, Hernandez-Arana S, Tlacuilo-Parra A. Nevoid acanthosis nigricans: Report of four cases localized to the umbilicus. Indian J Dermatol Venereol Leprol. 2021; 87(5): 660-5.
Gregoriou S, Anyfandakis V, Kontoleon P, Christofidou E, Rigopoulos D, Kontochristopoulos G. Acanthosis nigricans associated with primary hypogonadism: successful treatment with topical calcipotriol. J Dermatolog Treat. 2008; 19(6): 373-5.
Ehsani A, Noormohammadpour P, Goodarzi A, Mirshams SM, Hejazi SP, Hosseini E, et al. Comparison of long-pulsed alexandrite laser and topical tretinoin-ammonium lactate in axillary acanthosis nigricans: A case series of patients in a before-after trial. Caspian J Intern Med. 2016; 7(4): 290-3.
Treesirichod A, Chuenboonngarm S, Kritsanaviparkporn C. The efficacy and safety of 20% urea cream and 10% urea cream in the treatment of acanthosis nigricans in adolescents, a randomized comparative double-blind study. J Cosmet Dermatol. 2022; 21(7): 2859-64.
Treesirichod A, Thaneerat N, Kangvanskol W. A comparison of the efficacy and safety profiles of 10% salicylic acid and 10% urea creams in treating acanthosis nigricans in adolescents: a randomized double-blinded study. Arch Dermatol Res. 2023; 315(7): 2091-7.
Zayed A, Sobhi RM, Abdel Halim DM. Using trichloroacetic acid in the treatment of acanthosis nigricans: a pilot study. J Dermatolog Treat. 2014; 25(3): 223-5.
Zaki NS, Hilal RF, Essam RM. Comparative study using fractional carbon dioxide laser versus glycolic acid peel in treatment of pseudo-acanthosis nigricans. Lasers Med Sci. 2018; 33(7): 1485-91.
Bauer LB, Ornelas JN, Elston DM, Alikhan A. Isotretinoin: controversies, facts, and recommendations. Expert Rev Clin Pharmacol. 2016; 9(11): 1435-42.
Bagatin E, Costa CS. The use of isotretinoin for acne - an update on optimal dosing, surveillance, and adverse effects. Expert Rev Clin Pharmacol. 2020; 13(8): 885-97.
Jeong KH, Oh SJ, Chon S, Lee MH. Generalized acanthosis nigricans related to type B insulin resistance syndrome: A case report. Cutis. 2010; 86(6): 299-302.
Katz RA. Treatment of acanthosis nigricans with oral isotretinoin. Arch Dermatol. 1980; 116(1): 110-1.
Walling HW, Messingham M, Myers LM, Mason CL, Strauss JS. Improvement of acanthosis nigricans on isotretinoin and metformin. J Drugs Dermatol. 2003; 2(6): 677-81.
Sriboonnark L, Arora H, Falto-Aizpurua L, Choudhary S, Connelly EA. Costello syndrome with severe nodulocystic acne: unexpected significant improvement of acanthosis nigricans after oral isotretinoin treatment. Case Rep Pediatr. 2015; 2015: 934865.
Swineford SL, Drucker CR. Palliative treatment of paraneoplastic acanthosis nigricans and oral florid papillomatosis with retinoids. J Drugs Dermatol. 2010; 9(9): 1151-3.
Ozdemir M, Toy H, Mevlitoglu I, Demirkesen C. Generalized idiopathic acanthosis nigricans treated with acitretin. J Dermatolog Treat. 2006; 17(1): 54-6.
Skiljevic DS, Nikolic MM, Jakovljevic A, Dobrosavljevic DD. Generalized acanthosis nigricans in early childhood. Pediatr Dermatol. 2001; 18(3): 213-6.
Pollock S, Swamy MR, Tremblay ES, Shen L. Acanthosis nigricans in the pediatric population: a narrative review of the current approach to management in primary care. Pediatr Med. 2022; 5.
Akovbyan VA, Talanin NY, Arifov SS, Tukhvatullina ZG, Musabayev AN, Baybekov IM, et al. Successful treatment of acanthosis nigricans with etretinate. J Am Acad Dermatol. 1994; 31(1): 118-20.
Mork NJ, Rajka G, Halse J. Treatment of acanthosis nigricans with etretinate (Tigason) in a patient with Lawrence-Seip syndrome (generalized lipodystrophy). Acta Derm Venereol. 1986; 66(2): 173-4.
Baker H, Barth JH. Acanthosis nigricans. Br J Dermatol. 1983; 109: 101-3.
Ferrannini E. The target of metformin in type 2 diabetes. N Engl J Med. 2014; 371(16): 1547-8.
Chang JE, Choi MS. A Molecular Perspective on the Potential Benefits of Metformin for the Treatment of Inflammatory Skin Disorders. Int J Mol Sci. 2020; 21(23): 8960.
Radu AM, Carsote M, Dumitrascu MC, Sandru F. Acanthosis Nigricans: Pointer of endocrine entities. Diagnostics (Basel). 2022; 12(10): 2519.
Hermanns-Le T, Hermanns JF, Pierard GE. Juvenile acanthosis nigricans and insulin resistance. Pediatr Dermatol. 2002; 19(1): 12-4.
Lee PJ, Cranston I, Amiel SA, O'Rahilly S, Green AA. Effect of metformin on glucose disposal and hyperinsulinaemia in a 14-year-old boy with acanthosis nigricans. Horm Res. 1997; 48(2): 88-92.
Bellot-Rojas P, Posadas-Sanchez R, Caracas-Portilla N, Zamora-Gonzalez J, Cardoso-Saldana G, Jurado-Santacruz F, et al. Comparison of metformin versus rosiglitazone in patients with Acanthosis nigricans: A pilot study. J Drugs Dermatol. 2006; 5(9): 884-9.
Tankova T, Koev D, Dakovska L, Kirilov G. Therapeutic approach in insulin resistance with acanthosis nigricans. Int J Clin Pract. 2002; 56(8): 578-81.
Wasniewska M, Arrigo T, Crisafulli G, Lombardo F, Messina MF, Salzano G, et al. Recovery of acanthosis nigricans under prolonged metformin treatment in an adolescent with normal weight. J Endocrinol Invest. 2009; 32(11): 939-40.
Barbato MT, Criado PR, Silva AK, Averbeck E, Guerine MB, Sa NB. Association of acanthosis nigricans and skin tags with insulin resistance. An Bras Dermatol. 2012; 87(1): 97-104.
Adderley-Rolle EM, Peter S. Regression of acanthosis nigricans with the addition of Sitagliptin and Pioglitazone. West Indian Med J. 2015; 64(2): 160-1.
Sett A, Pradhan S, Sancheti K, Basu D, Datta A, Biswas L, et al. Effectiveness and safety of metformin versus Canthex in patients with acanthosis nigricans: A randomized, double-blind controlled trial. Indian J Dermatol. 2019; 64(2): 115-21.
Lunetta M, Di MM, Le MR, Burrafato S. Long-term octreotide treatment reduced hyperinsulinemia, excess body weight and skin lesions in severe obesity with acanthosis nigricans. J Endocrinol Invest. 1996; 19(10): 699-703.
Sinha S, Schwartz RA. Juvenile acanthosis nigricans. J Am Acad Dermatol. 2007; 57(3): 502-8.
Sun H, Wang X, Chen J, Gusdon AM, Song K, Li L, et al. Melatonin treatment improves insulin resistance and pigmentation in obese patients with acanthosis nigricans. Int J Endocrinol. 2018; 2018: 2304746.
Rosenbach A, Ram R. Treatment of Acanthosis nigricans of the axillae using a long-pulsed (5-msec) alexandrite laser. Dermatol Surg. 2004; 30(8): 1158-60.
Elmasry MF, Khalil MMF, Badawi A, Zaki NS, Fahim A. Efficacy of fractional carbon dioxide (CO(2)) laser versus q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) and potassium-titanyl-phosphate (KTP) Lasers in the treatment of acanthosis nigricans. Clin Cosmet Investig Dermatol. 2023; 16: 705-15.
Katz TM, Goldberg LH, Firoz BF, Friedman PM. Fractional photothermolysis for the treatment of postinflammatory hyperpigmentation. Dermatol Surg. 2009; 35(11): 1844-8.
Jacobs A, Elston D, Cho S, Acanthosis nigricans of the lips treated with carbon dioxide laser ablation. J Am Acad Dermatol. 2011; 64(2): AB172.
Abu Oun AA, Ahmed NA, Hafiz HSA. Comparative study between fractional carbon dioxide laser versus retinoic acid chemical peel in the treatment of acanthosis nigricans. J Cosmet Dermatol. 2022; 21(3): 1023-30.
Leerapongnan P, Jurairattanaporn N, Kanokrungsee S, Udompataikul M. Comparison of the effectiveness of fractional 1550-nm erbium fiber laser and 0.05% tretinoin cream in the treatment of acanthosis nigricans: a prospective, randomized, controlled trial. Lasers Med Sci. 2020; 35(5): 1153-8.
Epstein E. Podophyllin therapy in acanthosis nigricans. J Invest Dermatol. 1951; 17(1): 7.
Huang TH, Wang PW, Yang SC, Chou WL, Fang JY. Cosmetic and therapeutic applications of fish oil's fatty acids on the skin. Mar Drugs. 2018; 16(8).
Sherertz EF. Improved acanthosis nigricans with lipodystrophic diabetes during dietary fish oil supplementation. Arch Dermatol. 1988; 124(7): 1094-6.
Bonnekoh B, Thiele B, Merk H, Mahrle G. Systemic photochemotherapy (PUVA) in acanthosis nigricans maligna: Regression of keratosis, hyperpigmentation and pruritus. Z Hautkr. 1989; 64(12): 1059-62.
Schmolke B, Grotmann P, Kreusch J, Wolff HH. Surgical therapy of lip involvement in acanthosis nigricans maligna. Hautarzt. 1994; 45(12): 875-7.
Butt N, Mahmood K, Kanwal N, Ashfaq F. Acanthosis nigricans in patients with type ii diabetes mellitus at a tertiary care hospital of Lahore. Journal of Bahria University Medical and Dental College. 2023; 13(1): 13-7.
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