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FAMILIAL ACANTHOSIS NIGRICANS
Author(s) -
DHAR SANDIPAN,
DAWN GOUTAM,
KANWAR AMRINDER J.,
NADA RITAMBHARA
Publication year - 1996
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4362.1996.tb03278.x
Subject(s) - medicine , hyperpigmentation , acanthosis nigricans , acanthosis , dermis , dermatology , hyperkeratosis , inframammary fold , axilla , pigmentation disorder , physical examination , dyskeratosis , anatomy , areola , pathology , surgery , insulin resistance , cancer , implant , breast cancer , obesity
A 15‐year‐old girl (Case 1), presented with thickening and hyperpigmentation of the skin over the dorsa of both hands and feet, and the periorbital area. Hyperpigmentation at the above sites was noticed 6 months after birth; gradually the skin became thickened over the years. Her 39‐year‐old mother (Case 2) also had similar skin lesions since infancy. On enquiry, the girl's one brother (27 years old), maternal uncle (55 years old), and maternal grandfather (77 years old) were found to have similar skin lesions (Fig. 1). No abnormality was detected on general physical and systemic examinations. Both the patient and her mother were of average build, nutrition, and weight. Dental, ophthalmologic, and endocrinologic examinations were essentially normal. Examination of the skin in both cases revealed hyperpigmented velvety plaques of skin over the dorsa of both hands and feet (Fig. 2, 3) helix of pinnae, and periorbital areas. The sides of the neck and the axillary, inframammary, and inguinal folds were minimally affected. Hairs, nails, and teeth were normal. Histopathologic examination of the skin from both the dorsum of a hand and face in both patients showed almost identical features. The epidermis appeared to be thinned out over the tips of dermal papillae. There was hyperkeratosis with dermal papillae projecting upwards as fingerlike projections; however, there was mild to moderate acanthosis in the valleys between the papillae (Fig. 4). The rete ridges were poorly developed. There was no proliferation or increased activity of basal melanocytes. The dermis appeared normal. The following investigations were carried out and were within normal limits: complete blood count, urinalysis, serum sodium, potassium, chloride, calcium, blood sugar, blood urea, creatinine, total bilirubin, transaminases, and alkaline phosphatase; chest roentgenogram and electrocardiogram (ECG). The patients were advised to use topical application of 0.05% retinoic acid and gradual reduction in hyperpigmentation and hyperkeratosis was observed over a period of 8 to 12 weeks. The nature of the condition was explained to the patients.