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Acanthosis nigricans in Child
See also in: Anogenital
Other Resources UpToDate PubMed

Acanthosis nigricans in Child

See also in: Anogenital
Contributors: Kyle Cheng MD, Belinda Tan MD, PhD, Oyetewa Oyerinde MD, Callyn Iwuala MD, Susan Burgin MD
Other Resources UpToDate PubMed


Acanthosis nigricans (AN) is a localized skin disorder typically characterized by symmetric hyperpigmented velvety plaques in skin folds. It is due to overstimulation of fibroblasts and keratinocytes via insulin-like growth factor receptors and tyrosine kinase receptors. AN is most commonly associated with obesity and is a marker of insulin resistance. A 2007 study found that up to 90% of youth with AN also carried a diagnosis of diabetes mellitus.

AN is classified into 8 types:

I. Obesity-associated – Most common; linked to diabetes, insulin resistance, high body mass index (BMI), metabolic syndrome, etc.

II. Malignancy-associated / cutaneous paraneoplastic syndrome – Very rare in children, but has been documented with juvenile gastric adenocarcinoma (most common), Wilms tumor, and osteogenic sarcomas.

III. Drug-induced – Niacin (nicotinic acid) is the most closely associated medication, but AN can also be caused by oral contraceptives, corticosteroids, diethylstilbestrol, heroin, fusidic acid, methyltestosterone, protease inhibitors, and folate.

IV. Syndromic – Related to a specific syndrome, eg, HAIR-AN (hyperandrogenism, insulin resistance, and acanthosis nigricans) syndrome, polycystic ovarian syndrome, or autoimmune-disease, among others.

V. Acral – Affects elbows, knees, and knuckles. Typically seen in healthy sub-Saharan African patients.

VI. Unilateral – Also called nevoid. Usually represents an epidermal nevus in childhood.

VII. Benign – Rare autosomal dominant form developing at birth or during childhood. Typically stabilizes or regresses during puberty.

VIII. Mixed – Any 2 or more of the above types combined.


L83 – Acanthosis nigricans

402599005 – Acanthosis nigricans

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Last Updated:10/23/2018
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Acanthosis nigricans in Child
See also in: Anogenital
A medical illustration showing key findings of Acanthosis nigricans : Axilla, Hyperpigmented patch, Neck
Clinical image of Acanthosis nigricans - imageId=40959. Click to open in gallery.  caption: 'Acanthotic, thickened, ridged, and hyperpigmented plaques on the posterior neck.'
Acanthotic, thickened, ridged, and hyperpigmented plaques on the posterior neck.
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