What causes acanthosis nigricans?

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Last updated: March 27, 2025View editorial policy

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From the Research

Acanthosis nigricans is primarily caused by insulin resistance, which is often associated with obesity, as evident in the most recent study published in 2022 1. This condition appears as dark, velvety patches of skin, typically in body folds like the neck, armpits, and groin. Some key points to consider include:

  • Common causes of acanthosis nigricans include obesity, type 2 diabetes, hormonal disorders like polycystic ovary syndrome (PCOS) and Cushing's syndrome, certain medications, and rarely, certain cancers.
  • The excess insulin in the bloodstream interacts with insulin-like growth factor receptors on skin cells, stimulating their growth and causing the characteristic skin changes, as discussed in a study from 1989 2.
  • Treatment focuses on addressing the underlying cause, particularly through weight loss and improved blood sugar control in cases related to insulin resistance, as highlighted in a 2018 review of current treatment options 3.
  • Early recognition of acanthosis nigricans is important because it can be a cutaneous manifestation of a variety of systemic disorders and, rarely, as a sign of internal malignancy, as noted in the 2022 updated review 1.
  • The diagnosis is mainly clinical, based on the characteristic appearance and typical sites of the lesions, and clinicians should be familiar with the clinical signs, evaluation, diagnosis, and therapy of acanthosis nigricans due to its link with underlying diseases. Some other factors that may contribute to the development of acanthosis nigricans include:
  • Genetics, as some people have a hereditary form of the condition
  • Certain medications, such as nicotinic acid, oral contraceptives, and corticosteroids
  • Rarely, certain cancers, particularly stomach cancer, as reported in a case study from 2010 4
  • Other underlying endocrinopathies or systemic disorders, as discussed in the 2004 study on the obesity syndrome and acanthosis nigricans 5.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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