Exogenous Insulin-Derived Acanthosis Nigricans

Mailler-Savage, Erica; Adams, Brian B.

doi:10.1001/archdermatol.2007.27

Cited by 15 publications

(10 citation statements)

References 3 publications

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“…A total of 13 acanthosis nigricans-inducing drugs were identified from the systematic literature search. These drugs included nicotinic acid, [4][5][6][7][8][9][10][11][12] niacinamide, 13 insulin, [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] aripiprazole, 29 oral corticosteroids, 12,30,31 somatotrophin, 32 oral contraceptives, 33 diethylstilbestrol, [34][35][36] testosterone, 37,38 pituitary extract of β-Melanocyte stimulating hormone (β-MSH), 39 triazinate, 40 amprenavir, 41 palifermin, 42,43 and fusidic acid ointment. 44 We discuss each drug in detail below and provide a summary in Table 1 15 3 months, 15 1 year, 16 3 months, 18 4 months 22…”

Section: Study Selectionmentioning

confidence: 99%

Drug‐induced acanthosis nigricans: A systematic review and new classification

Mourad

Haber

2021

Dermatologic Therapy

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Drug-induced acanthosis nigricans is an uncommon subtype of acanthosis nigricans and the data on this topic is not well understood by clinicians as it is presently limited in the literature. Previous reports of drug-induced acanthosis nigricans have simply consisted of a list of drugs possibly implicated in causing acanthosis nigricans. Several drugs listed are based on single case reports without biopsy confirmation, report of clearing on stopping the drug or reporting on whether acanthosis nigricans recurred with drug rechallenge. A comprehensive literature search was conducted using PubMed, EMBASE(Ovid), Cochrane Library, Scopus, and Web of Science electronic databases. The authors screened the initial result of the search strategy by title and abstract using the following inclusion criteria: eligible studies included those with patients who developed acanthosis nigricans secondary to a drug. This study is the first to comprehensively review the drugs that have been implicated in the development of acanthosis nigricans. A total of 38 studies were included in the systematic review, and a total of 13 acanthosis nigricans inducing drugs were identified. Nicotinic acid and insulin were the two most significant drugs that were reported to cause acanthosis nigricans. By using the results of this study, we created a revised classification system of drug-induced acanthosis nigricans which can be used as a concise framework for clinicians to refer to.

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Section: Study Selectionmentioning

confidence: 99%

Drug‐induced acanthosis nigricans: A systematic review and new classification

Mourad

Haber

2021

Dermatologic Therapy

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“…Later similar presentations were reported in two more cases of diabetes, developing AN over lower abdomen. [3,4] The cases presented here are different in terms of age of the patient and type of diabetes. Our index case is the first patient developing AN over an aberrant site of insulin administration, that is, posterior aspect of both upper arms.…”

Section: Net Lettermentioning

confidence: 99%

“…Regular rotations of the insulin injections, [2][3][4] along with, topical keratolytics like salicylic acid, [4] lactic acid, can be tried for its treatment. Apart from prescribing the correct insulin, it is also essential to guide and educate patient regarding the proper technique of insulin administration, as it will not only avoid lipodystrophy but also AN.…”

Section: Net Lettermentioning

confidence: 99%

Acanthosis nigricans--An uncommon cutaneous adverse effect of a common medication: Report of two cases

Sawatkar¹,

Dogra²,

Bhadada³

et al. 2013

Indian J Dermatol Venereol Leprol

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Figure 1: Well-defined brownish-black, velvety to verrucous, elevated plaque, localized over the posterior aspect of both upper arms a b cSir, The incidence of diabetes mellitus (DM) is on the rise. Insulin forms an indispensible part in the management of patients with DM. Acanthosis nigricans (AN) is a hyperpigmented, hyperkeratotic, velvety plaque, occurring commonly over the posterior aspect of the neck, axilla, and groins. AN as a local side effect of insulin injection is very rare. Herein, we report two patients with type 1 DM (T1DM) developing AN over the site of insulin administration.

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“…An AN-like lesion at the insulin injection site has been reported in at least three cases. [5][6][7] The histopathological findings of the previous cases included hyperkeratosis, papillomatosis and acanthosis. And it was suggested that activation of the insulin-like growth factor receptor (IGFR) might be related to classic AN.…”

Section: Reportmentioning

confidence: 99%

“…8 Hence, the excessively high level of insulin at an injection site may cause an AN-like lesion. 7 The dermis of patients with documented AN-like lesions shows thickened collagenous connective tissue 5,7 and mild to moderate perivascular lymphocytic infiltration. [5][6][7] Amyloid deposits in the dermis and subcutaneous tissue have not been described in previously reported cases, thus to our knowledge, this is the first patient presenting with the characteristic features of both Alns amyloidosis and an AN-like lesion.…”

Section: Reportmentioning

confidence: 99%

Coexistence of insulin-derived amyloidosis and an overlying acanthosis nigricans-like lesion at the site of insulin injection

Kudo-Watanuki¹,

Kurihara²,

Yamamoto³

et al. 2012

Clinical and Experimental Dermatology

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A 59-year-old patient with diabetes mellitus had been treated with human recombinant insulin for 4 years. He developed a solid mass on his left abdomen at the insulin injection site, which had an overlying pigmented verrucous plaque and keratinized papules, similar to acanthosis nigricans (AN). On histological examination, the mass was found to contain a deposit of amyloid in the dermis, with hyperkeratosis, papillomatosis and acanthosis in the epidermis. Using immunohistochemistry, the amyloid deposits were found to be positive for insulin. A few cases of localized insulin-derived amyloid deposits at injection sites have been reported previously, but none had significant epidermal changes. The coexistence of dermal insulin-derived amyloidosis and an overlying AN-like change, as found in our patient, has not been reported previously, to our knowledge. The presence of a tumour-like lesion at the injection site should be carefully examined, as injection of insulin into amyloid deposits can result in insulin resistance.

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Exogenous Insulin-Derived Acanthosis Nigricans

Cited by 15 publications

References 3 publications

Drug‐induced acanthosis nigricans: A systematic review and new classification

Drug‐induced acanthosis nigricans: A systematic review and new classification

Acanthosis nigricans--An uncommon cutaneous adverse effect of a common medication: Report of two cases

Coexistence of insulin-derived amyloidosis and an overlying acanthosis nigricans-like lesion at the site of insulin injection

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