Acanthosis Nigricans in Adolescents versus Adults; Association with Obesity, Diabetes and Hypertension
DOI:
https://doi.org/10.51985/JBUMDC2022053Keywords:
Acanthosis nigricans, BMI, HAIR-AN syndrome, Obesity, PCOAbstract
Objectives: Acanthosis nigricans presents as black velvety plaques on flexural surfaces which is associated with obesity,
T2DM and HTN. To study sites and types of AN (Acanthosis Nigricans) in adolescents Vs. adults and its associations.
Study design & setting: This cross sectional study was conducted from IstMar-31stAug 2021 at RIHS Islamabad after
ethical approval.
Methodology: Adolescents and adult cases of both the genders with AN were included by convenience sampling. Critically
ill cases, endocrine disorders, pregnancy and malignancy were excluded.57 adolescents and 57 gender matched adults were
included. After the detailed clinical evaluation, BMI, waist circumference, sites and types of AN were documented. Blood
sugars and workup for PCO’s, suggested. Data was analyzed by SPSS 21. Chi-square test and Mann-Whitney-U test applied.
Results: Out of 114 cases,77(67.5%) were females. The mean age was 17.99+14.18 years and mean BMI was 31.63+6.92
kg/m2.Obesity was observed in 75(65.8%); 44(77.2%) adolescents Vs. 31(54.4%) adults (p=0.010). Mean waist circumference
was 37.03+3.74 inches.AN at Neck 113(99.1%) and benign AN 111(97.4 %) were the most frequent. The types of AN were
associated with obesity, DM 31(27.2%) and HTN 27(23.7%) (p<0.05).
Conclusions: Benign and HAIR-AN were most frequent. Adolescents with AN have significantly higher obesity than
adults. HTN was significantly higher in adults. DM in AN was observed regardless of age group. It is suggested to screen
all AN cases regardless of age or gender for obesity, HTN and DM. Early diagnosis may contribute to improve quality of
life, prevent morbidity of systemic diseases and improve outcome
References
Das A, Misra P, Panda S. Childhood acanthosis nigricans.
Indian Journal of Paediatric Dermatology. 2019;20(3):199-
DOI: http://dx.doi.org/10.4103/ijpd.IJPD_34_18.
Prakash N, Kumar YH, Belliappa PR. A descriptive caseControl study of 100 patients of acanthosis nigricans and its
utility to detect metabolic syndrome.Clinical Dermatology
Review. 2020; 4(1):17-22. DOI: https://www.ijpd.in/text.
asp?2019/20/3/199/261877.
Sayarifard F, Sayarifard A, Allahverdi B, Ipakchi S, Moghtaderi
M & Yaghmaei B, et al. Prevalence of acanthosis nigricans
and related factors in Iranian obese children. Journal of clinical
and diagnostic research:2017: 11(7).DOI: https://doi.org/
7860/JCDR/2017/24902.10203.
Das A, Datta D, Kassir M, Wollina U, Galadari H, Lotti T, et
al. Acanthosis nigricans: A review. Journal of Cosmetic
Dermatology. 2020; 19(8):1857-1865. DOI: https://doi.org/
1111/jocd.13544.
Ng HY. Acanthosis nigricans in obese adolescents: prevalence,
impact, and management challenges. Adolescent health,
medicine and therapeutics. 2017; 8:1-10. DOI: https://doi
.org/10.2147/AHMT.S103396.
Palhares H, Zaidan PC , Dib F, Silva A , Resende D & Borges
MF, et al. Association between acanthosis nigricans and other
cardiometabolic risk factors in children and adolescents with
overweight and obesity. Revista Paulista de Pediatria. 2018;36:
-308. DOI: https://doi.org/10.1590/1984-0462/;2018; 36;
;00017.
Wolff C, Hoang S, Flannery D, Wermuth L .Diet, Overweight,
Elevated Blood Pressure, and Acanthosis Nigricans Among
K-9th Grade Native American Students. Californian Journal
of Health Promotion. 2006; 4(4):77-87. DOI: http://dx.doi.org/1
32398/cjhp.v4i4.1989.
Lopez-Alvarenga JC, Chittoor G, Paul SF, Puppala S, Farook
VS, Fowler SP, et al. Acanthosis nigricans as a composite
marker of cardiometabolic risk and its complex association
with obesity and insulin resistance in Mexican American
children. PloS one. 2020;15(10):e0240467. DOI: https://doi.
org/10.1371/journal.pone.0240467.
Feng, JG, Guo Y, Ma LA, Xing J , Sun RF & Zhu W, et al.
Prevalence of dermatologic manifestations and metabolic
biomarkers in women with polycystic ovary syndrome in
north China. Journal of cosmetic dermatology. 2018;17 (3):511-
DOI: https://doi.org/10.1111/jocd.12387.
Adibi N, Robati RM. Skin and metabolic syndrome: A review
of the possible associations. J Res Med Sci. 2021; 26 :16.
DOI: https://doi.org/10.4103/jrms.JRMS_585_20.
Soliman AT, Al-Suwaid AR, Gamil H, Asfour M. Prevalence
and significance of acanthosis nigricans in children and
adolescents. Annals of Saudi medicine. 1996;16(4):424-428.
DOI: https://doi.org/10.5144/0256-4947.1996.424.
Jorwal P, Keshwani P, Verma R. Association of acanthosis
nigricans with anthropometric and biochemical parameters
in young Indian males: Annals of Nigerian Medicine:2014:
(2):65-68. DOI: https://doi.org/10.4103/0331-3131.153354.
Maguolo A, Maffeis C. Acanthosis nigricans in childhood: A
cutaneous marker that should not be underestimated, especially
in obese children. Acta Paediatr. 2020:109(3):481-487. DOI:
https://doi.org/10.1111/1346-8138.12052.
Verma S, Vasani R, Joshi R, Phiske M, Punjabi P, Toprani T,
et al. A descriptive study of facial acanthosis nigricans and
its association with body mass index, waist circumference
and insulin resistance using HOMA2 IR. Indian Dermatol
Online J. 2016; 7(6):498-503. DOI: https://doi.org/10.4103/
-5178.193898.
Daye M, Eklioglu BS, Atabek ME. Relationship of acanthosis
nigricans with metabolic syndrome in obese children. Journal
of Pediatric Endocrinology and Metabolism. 2020;
(12):1563-1568. DOI: https://doi.org/10.1515/jpem-2020-
Zhu C, Cui R, Gao M, Rampersad S, You H, Sheng C, et al.
The Associations of Serum Uric Acid with Obesity-Related
Acanthosis nigricans and Related Metabolic Indices. Int J
Endocrinol. 2017:5438157:1-9. DOI:https://doi.org/10.
/2017/5438157.
Reinehr T. Type 2 diabetes mellitus in children and adolescents.
World journal of diabetes. 2013; 4(6):270-281. DOI: https://doi.
org/10.4239/wjd.v4.i6.270.
G S, A B, Kamath A, Shivaprakash P, Adhikari P ,Up R,et al
. Acanthosis nigricans in PCOS patients and its relation with
type 2 diabetes mellitus and body mass at a tertiary care
hospital in southern India. Journal of Clinical and Diagnostic
Research: JCDR.2013; 7(2): 317–319. DOI:
https://doi.org/10.7860/JCDR/2013/4930.2756.
Xi B, Zong X, Kelishadi R, Litwin M, Hong YM , Poh BK,
et al .International Waist Circumference Percentile Cutoffs
for Central Obesity in Children and Adolescents Aged 6 to
Years. J Clin Endocrinol Metab. 2020; 105 (4):e1569-
e1583. DOI: https://doi.org/10.1210/clinem/dgz195.
Kobaissi HA, Weigensberg MJ, Ball GD, Cruz ML, Shaibi
GQ, Goran MI, et al. Relation between acanthosis nigricans
and insulin sensitivity in overweight Hispanic children at risk
for type 2 diabetes. Diabetes Care.2004 ; 27(6):1412-6. DOI:
https://doi.org/10.2337/diacare.27.6.1412.
Rodríguez-Gutiérrez R, de la O-Cavazos ME, SalcidoMontenegro A, Sanchez-Garcia A, Gomez-Flores M, GonzalezNava V, et al. Acanthosis Nigricans in the Knuckles of Infants:
A Novel Clinical Marker of High Metabolic Risk. Diabetes
Therapy. 2019:10(6):2169-81.DOI: https://doi.org/10.1007/
s13300-019-00703-1.
Popa ML, Popa AC, Tanase C, Gheorghisan-Galateanu AA.
Acanthosis nigricans: To be or not to be afraid. Oncol Lett.
:17(5):4133-4138.DOI: https://doi.org/10. 3892/ ol.2018
.9736.
Agrawal K, Mathur R, Purwar N, Mathur SK, Mathur DK.
Hyperandrogenism, Insulin Resistance, and Acanthosis
Nigricans (HAIR-AN) Syndrome Reflects Adipose Tissue
Dysfunction (“Adiposopathy” or “Sick Fat”) in Asian Indian
Girl. Dermatology 2021;237 :797 -805. DOI: https://doi.org/10.
/000512918.
Fasunla JA, Ijaduola GT. Acanthosis nigricans in the head
and neck region. Ann Ib Postgrad Med. 2008;6(1):53-56.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Furquana Niaz, Nadia Shams, Naresh Kumar, Irfan Sheikh, Nayer-ul- Islam, Najia Ahmed
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0