INTRODUCTION: There is no study in literature for analyzing acanthosis nigricans (AN) in psychotropic induced obesity or hypercholesterolemia. AIM: To assess the prevalence and explore the predictors and morphological patterns in AN in patients on antipsychotics induced hypercholesterolemia versus those with diabetes mellitus. MATERIALS AND METHODS: 491 schizophrenia patients on second generation antipsychotics were screened. 26 out of 491 patients have AN and cholesterol 200 mg/dl but non-diabetic. We used MannWhitney U-test, Pearsons 2 test, Fischer Exact and Spearmans correlation coefficient. RESULTS: In the group of antipsychotics induced hypercholesterolemia having developed AN in 5.29% (26 out of 491) of individuals, we observed significance of Burkes knuckle (p 0.001), knee (p = 0.002), elbow (p = 0.042) compared to patients without hypercholesterolemia. Interestingly Burkes neck severity (p 0.001), neck texture (p = 0.001) and axilla (p = 0.007) index also showed marked differences on MannWhitney U-test and Wilcoxson W-test. On Spearmans correlation coefficient antipsychotics induced hypercholesterolemia was found to affect most positively and significantly as the emergence of AN specifically for neck texture ( = 0.413, p = 0.003) compared to other bodily regions. CONCLUSION: About 5.29% prevalence of AN in the group having obesity secondary to psychotropic drugs which was significantly less than what even non-obese, insulin dependent diabetic patients who almost had 13.55% prevalence, close to three times. This suggests that diabetes is strongly linked with occurrence of AN lesions and might reflect the continuity in the paradigm of metabolic syndrome as its definitive predictor of severity while obesity is the initiation of phase shift in the process.
Introduction: Metabolic syndrome is a cluster of metabolic risk factors which includes central obesity, glucose intolerance, hyperinsulinemia, low HDL cholesterol, high triglycerides and hypertension. Acanthosis nigricans, the principal abnormality in metabolic syndrome (MetS), is an easily identifiable asymptomatic non-specific reaction pattern of skin characterized by thickened, hyperpigmented plaques associated with hyperinsulinemia. Aims and Objectives: To determine the prevalence of metabolic syndrome and AN in adolescent and adults and the association between benign acquired AN and metabolic syndrome. Materials and Methods: A sample of 40 patients selected from Dermatology outpatient department who satisfied the selection criteria to evaluate the prevalence of AN and its association with insulin resistance and the clustering of the MetS components. Epidemiological, clinical and anthropometric characteristics (height, weight, waist circumference) were measured and BMI was calculated. We used the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria for the diagnosis of metabolic syndrome. Results: The average age of the study population was 26.8 years, with male to female ratio of 1:1. The prevalence of acanthosis nigricans among females is greater than males, which also showed a positive correlation with increase in the age. BMI was higher in patients with metabolic syndrome than the patients without metabolic syndrome.There was a statistically significant correlation of increasing incidence of AN with each component of metabolic syndrome. Conclusion: There is an increased prevalence of MetS in the individuals with AN which was statistically highly significant. Hence, early screening of a simple clinical marker like AN is helpful in identification of MetS components.
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