Suggest Treatment For Acanthosis Nigricans

Posted on Mon, 15 May 2017

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 15 May 2017 Answered on

Fri, 2 Jun 2017 Last reviewed on

Question : Good morning doctor...

I want your help...I have a pigmented skin disorder...some area of body very dark e.g neck, underarms, under eyes not dark circle but pigmentation. plz help

Answered by Dr. Dr. Kakkar (33 minutes later)

Brief Answer:
Kindly upload image. Possibly it is Acanthosis nigricans

Detailed Answer:
Hello. Thank you for writing to us

I am dr.kakkar (dermatologist). I have gone through your query and I have noted your concern.
I will keep a possibility of Acanthosis Nigricans which presents as dark velvety skin in these areas. I request you to kindly upload a few images in "Reports Section" so that I am able to guide you better.

Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. Kakkar (7 hours later)

please see attached images of underarms and neck portion

Answered by Dr. Dr. Kakkar (15 hours later)

Brief Answer:
Lichen planus pigmentosus

Detailed Answer:
Thank you.

I have viewed the images.
I would keep a possibility of lichen planus pigmentosus which can present as hyperpigmented patches such as these. It does not look like acanthosis nigricans as I supposed previously.
I suggest you to apply momate XL cream once daily on all affected sites. Use for at least 3-4 weeks initially and then follow up.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (2 hours later)

thank you for your advice. but I dnt find this is lichen planus as I dnt feel any skin allergy, redness, and rashes. please tell me if I am wrong.

Answered by Dr. Dr. Kakkar (5 hours later)

Brief Answer:
Clarification

Detailed Answer:
Hi.

Lichen planus pigmentosus(LPP) is a variant of lichen planus (LP). While LP is itchy and presents as raised, purple colored lesions, LPP presents as flat dark/ bluish patches and is usually asymptomatic and also commonly involves covered areas of the body like neck, underarms, trunk etc.
Moreover in the images the deep folds of axilla are spared which distinguishes it from acanthosis nigricans(AN). Another distinguishing point is that skin texture in AN is velvetty whereas it is normal in LPP.
I suggest you to use the cream. In addition you may also take a Vitamin B 12 supplement e.g Cap. cobadex forte once daily.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (4 minutes later)

Thank you..i will keep in mind these prescriptions....ð...could you please let me know reason of LPP...

Answered by Dr. Dr. Kakkar (15 hours later)

Brief Answer:
LPP

Detailed Answer:
Hi.

LPP has an unknown etiology. Sun has been implicated but it can also occur in covered areas like flexures. It is certainly immune mediated and is more common in tropics and in asians.

Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. Kakkar (15 minutes later)

should I take specific precaution ?? please suggest

Answered by Dr. Dr. Kakkar (8 hours later)

Brief Answer:
Regarding managment of Lichen Planus Pigmentosus

Detailed Answer:
Hi.

Avoid sun and use a sunscreen on exposed sites like neck during the day. Apply momate-XL cream at night on all affected sites

Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Kakkar (23 minutes later)

Thank you for your reeply. i would like to close this discussion here. thank you for helping me in this matter. :)

Answered by Dr. Dr. Kakkar (8 minutes later)

Brief Answer:
You are welcome

Detailed Answer:
Hopefully you would benefit from treatment. Treatment is long term and result are slow. So be patient. Thank you for writing to us

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj