Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges

Abstract

Obesity in adolescence is a public health priority because it usually tracks into adulthood, resulting in enormous medical and social costs. This underscores the importance of early identification and intervention. Acanthosis nigricans (AN) was once considered a rare paraneoplastic dermatosis, but is now frequently observed in obese adolescents. Current understanding suggests that it is associated with insulin resistance and has a unique role in secondary prevention. The purpose of this narrative review is to provide a comprehensive overview of AN in obese adolescents, covering its history, current knowledge on the condition, its clinical significance, management challenges, and the direction of future research.

Paediatric obesity treatment had better outcomes when children were younger, well motivated and did not have acanthosis nigricans

“…In this study, we focused mainly on changes in BMI SDS, but we noticed that acanthosis nigricans was closely associated with the outcome. Acanthosis nigricans presents with insulin resistance, increases the risk for relative weight gain and reduces the likelihood of relative weight loss (28)(29)(30). In the current study, it had a very significant effect (p < 0.001) on the outcomes in all of our analyses and its presence was strongly associated with a poor outcome, although the children with acanthosis nigricans made more intervention visits.…”

Laparoscopic sleeve gastrectomy improves body composition and alleviates insulin resistance in obesity related acanthosis nigricans

“…Acanthosis nigricans was once considered a rare paraneoplastic dermatosis, but is now frequently observed in obese patients, especially in adolescents [ 22 ]. The exact pathogenesis of obesity-associated AN is complicated and has yet to be fully elucidated.…”

A follow-up during puberty in a Japanese girl with type A insulin resistance due to a novel mutation in <i>INSR</i>

“…The direct and indirect activations of the IGF-1 receptors by hyperinsulinemia trigger the proliferation of fibroblasts and keratinocytes, leading to the development of skin lesions ( 3 ). It is reported that the extent and severity of AN could parallel the degree of IR ( 4 ). In the present case, the reason for the lack of AN is unknown, but we speculate that IGF-1 resistance in skin cells at a receptor or post-receptor level or an inhibitory action of the mutant insulin receptor on IGF-1 receptor signaling in skin cells could contribute to this condition.…”