Posterolateral Neck Texture (Insulin Neck)

Payne, Katie S.; Rader, Ryan K.; Lastra, Guido; Stoecker, William V.

doi:10.1001/jamadermatol.2013.4054

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…Grading of AN was not found to be useful in determining insulin sensitivity in overweight Hispanic children. [45] Posterolateral neck texture has been found to be an early sign of IR by Payne et al [46] Neck but not axillary severity had a statistically significant correlation with IR values in adult diabetics. [47]…”

Section: Discussionmentioning

confidence: 99%

Association of acanthosis Nigricans and insulin resistance in indian children and youth – A HOMA2-IR based cross-sectional study

Nithun

Ranugha

Betkerur

et al. 2019

Indian Dermatol Online J

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Introduction: The American Diabetes Association includes acanthosis nigricans (AN) as an indicator of diabetes mellitus risk in overweight youth entering puberty. Some argue that AN is not an independent predictor of insulin resistance (IR), when body mass index (BMI) is controlled for. There is a paucity of studies on the association of AN and IR among children and young adults from India. Homeostatic model assessment-IR (HOMA2-IR), a computerized updated model, which is supposed to be superior to HOMA1-IR, has rarely been used for quantification of IR. Methods: Sixty cases (irrespective of BMI), aged 2–24 years with AN, and 30 age- and sex-matched normal weight controls were included. A thorough clinical examination and grading of AN was done. BMI, fasting glucose levels, and fasting insulin levels were measured for all. HOMA-IR calculator V.2.2.3 was used to calculate IR. Those with HOMA 2-IR >1.8 were considered insulin-resistant. Lifestyle modifications were advised for patients with IR. Results: The mean HOMA2-IR value in cases and controls was 2.422 and 1.322, respectively, which was statistically significant. Overweight and obese cases had 2.5 and 11.25 times higher risk of having IR, respectively, by logistic regression. The association of AN with IR was found to be statistically significant in normal weight cases when compared with controls ( P = 0.045). Grade 4 of neck severity ( P = 0.007), Grade 3 of neck texture ( P = 0.001), and Grade 4 of axillary severity ( P = 0.001) of AN were found to be significantly associated with IR. Limitations: The relatively small sample size may not reflect the accuracy of AN as a marker of IR. Conclusion: Acanthosis nigricans is associated with IR in both normal and obese. We propose that all children, adolescents, and youth with AN be screened for IR irrespective of BMI. Early identification and prompt lifestyle interventions may prevent or delay the onset of diabetes later.

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Section: Discussionmentioning

confidence: 99%

Association of acanthosis Nigricans and insulin resistance in indian children and youth – A HOMA2-IR based cross-sectional study

Nithun

Ranugha

Betkerur

et al. 2019

Indian Dermatol Online J

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“…They suggested that all patients with elevated BMI should be examined for insulin neck and if neck texture is normal, IR is less likely to be present. [16] IR occurs in 20-25% of the individuals. Types of IR are mentioned in Table 4.…”

Section: Acanthosis Nigricans and Insulin Resistancementioning

confidence: 99%

An approach to acanthosis nigricans

Phiske

2014

Indian Dermatol Online J

111

158

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Acanthosis nigricans (AN) is characterized by dark, coarse and thickened skin with a velvety texture, being symmetrically distributed on the neck, the axillae, antecubital and popliteal fossae, and groin folds, histopathologically characterized by papillomatosis and hyperkeratosis of the skin. A high prevalence of AN has been observed recently. Different varieties of AN include benign, obesity associated, syndromic, malignant, acral, unilateral, medication-induced and mixed AN. Diagnosis is largely clinical with histopathology needed only for confirmation. Other investigations needed are fasting lipoprotein profile, fasting glucose, fasting insulin, hemoglobin and alanine aminotransferase for obesity associated AN and radiological investigations (plain radiography, ultrasonography, magnetic resonance imaging/computerized tomography) for malignancy associated AN. The most common treatment modalities include retinoids and metformin.

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Posterolateral Neck Texture (Insulin Neck)

Cited by 2 publications

References 7 publications

Association of acanthosis Nigricans and insulin resistance in indian children and youth – A HOMA2-IR based cross-sectional study

Association of acanthosis Nigricans and insulin resistance in indian children and youth – A HOMA2-IR based cross-sectional study

An approach to acanthosis nigricans

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