Abstract

Silpa Siva Prasad, Anfi D. P., Shaiju S. Dharan and Amal A.*

ABSTRACT

Acanthosis nigricans is a skin disorder which characterized by dark, thick and velvety plaque of the skin which usually occurs in body folds but that may spread to other parts of the body. It could also be found on the elbow and knee and neck fold region. It is most likely caused by factors that stimulate epidermal keratinocyte and dermal fibroblast proliferation. The stimulating factor is probably insulin or an insulin like growth factor that copies the epidermal cell propagation. Hyperinsulinemia which activates the receptor result in hyperplasia of the skin. Treatment options for acanthosis nigricans is topical retinoids. However intermittent tretinoin was needed to maintain improvement as relapse was noted within a period of 4 weeks after discontinuation of treatment. The typical changes of hyperkeratosis and keratotic material between papillae were resolved on biopsy after 8 weeks of tretinoin application. Oral retinoids (isotretinoin), acitretin-0.8mg/kg(50mg) divided into two daily doses. After starting maintenance therapy of 25mg acitretin daily for 2 months lesions recovered that subsequently resolved with topical application of 0.1% retinoic acid can also be effective treatment options for acanthosis nigricans.[1,2]