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Acanthosis nigricans usually presents with dark, thick, velvety textured skin in neck and axillary folds commonly.
A large majority of cases are idiopathic.
It is more common in overweight individuals and is due to
insulin resistance that comes with being overweight.
Fasting insulin levels are frequently raised in these overweight individuals as a marker of insulin resistance.
Weight loss and controlling blood glucose levels through exercise and diet often improves symptoms in those who have insulin resistance and abnormal glucose tolerance.
Acanthosis may also be associated with endocrinopathies, such as
hypothyroidism, acromegaly, polycystic ovary disease, insulin-resistant diabetes, or Cushing's disease and should be considered/ ruled out in those who have widespread acanthosis.
Therefore people with acanthosis nigricans should be screened for diabetes, thyroid.
Topical tretinoin 0.05% cream once daily at night helps to lighten pigmentation along with weight loss, exercise and diet management.
Alpha-
Lipoic acid has been shown to increase insulin sensitivity and thereby reverses the acanthosis nigricans which arises as a result of insulin resistance states e.g Obesity and diabetes.
Lipoic acid is commercially available for prescription in acanthosis nigricans.
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