Original ArticlePrevalence of Acanthosis Nigricans in Newly-Diagnosed Type 2 Diabetes
Section snippets
INTRODUCTION
Acanthosis nigricans (AN) is a skin lesion that manifests as hyperpigmented brown velvety plaques in body areas of increased friction, most commonly the posterior neck, axillae, and medial thighs. The physiological mechanisms underlying AN are unclear, but probably involve local cutaneous growth factors and may be due to stimulation of insulin receptors or insulin-like growth factor receptors on epidermal and melatonin-containing dermal cells (1).
The medical significance of AN lies in its
METHODS
A retrospective review of medical records identified adult men and women over 18 years of age with newly diagnosed type 2 diabetes, as defined by the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (8). These patients were admitted to the University Diabetes Treatment Center, an ADA-certified 11-bed inpatient unit of Parkland Memorial Hospital in Dallas, Texas, between January 1998 and December 1999.
All patients were examined by attending medical faculty for presence
RESULTS
Of 216 patients newly diagnosed with diagnosed type 2 diabetes, 78 (36.1%) were found to have AN involving the posterior neck. Of these 78 affected patients, 36 (46.1%) were men and 42 (53.9%) were women, compared to 129 men (59.7%) and 87 women (40.3%) in the overall subject group. Patient ages were normally distributed about a mean of 35.5 ± 11.8 years. Additional clinical characteristics of the two subject groups are summarized in Table 1.
The mean BMI of the total sample population was 32.7
DISCUSSION
AN typically presents clinically as a darkening and thickening of the skin and is usually found in characteristic body areas. The lesion is associated with various systemic diseases, including some insulin resistance syndromes.
AN may appear in obese patients, and a metabolic basis for this association has been recently identified. Kahn et al noted AN as a consistent finding among patients with hyperinsulinemia caused by various forms of tissue resistance to insulin (9). Disorders associated
ACKNOWLEDGMENT
We thank the staff at the University Diabetes Treatment Center at Parkland Memorial Hospital for their invaluable help in the collection of data.
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