acanthosis nigricans

黒色表皮腫

WordNet

1. an abnormal but benign thickening of the prickle-cell layer of the skin (as in psoriasis)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/07/19 15:52:20」(JST)

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Acanthosis nigricans
Classification and external resources
Acanthosis nigricans on axilla
ICD-10	L83
ICD-9	701.2
OMIM	100600
DiseasesDB	58
MedlinePlus	000852
eMedicine	derm/1
MeSH	D000052

Acanthosis nigricans is a brown to black, poorly defined, velvety hyperpigmentation of the skin. It is usually found in body folds, such as the posterior and lateral folds of the neck, the axilla, groin, umbilicus, forehead, and other areas.

Causes

It typically occurs in individuals younger than age 40, may be genetically inherited, and is associated with obesity or endocrinopathies, such as hypothyroidism, acromegaly, polycystic ovary disease, insulin-resistant diabetes, or Cushing's disease. Not associated with hyperthyroidism.

Endocrine

The most common cause of acanthosis nigricans is insulin resistance, which leads to increased circulating insulin levels. Insulin spillover into the skin results in its abnormal increase in growth (hyperplasia of the skin). The high insulin concentrations probably activate growth factor receptors (perhaps the IGF1 receptor) that drive the proliferation of keratinocytes and melanocytes. The condition most commonly associated with insulin resistance is type 2 diabetes mellitus, but is also a prominent feature of obesity, polycystic ovary syndrome and, Donohue syndrome.

Malignant

In the context of a malignant disease, acanthosis nigricans is a paraneoplastic syndrome and is then commonly referred to as acanthosis nigricans maligna. Involvement of mucous membranes is rare and suggests a coexisting malignant condition.

When seen in individuals older than age 40, this disorder is commonly associated with an internal malignancy, usually adenocarcinoma, and most commonly of the GI tract or uterus; less commonly of the lung, prostate, breast, or ovary. The stomach is the most common site. Acanthosis nigricans of the oral mucosa or tongue is highly suggestive of a neoplasm, especially of the GI tract.

Other

Other causes of acanthosis nigricans are familial, drug-induced and idiopathic.

Types

Classification of Acanthosis nigricans according to Schwartz, 1994

• Benign acanthosis nigricans
• Acanthosis nigricans associated with obesity
• Syndromic acanthosis nigricans
• Malignant acanthosis nigricans
• Acral acanthosis nigricans
• Unilateral acanthosis nigricans
• Drug-induced acanthosis nigricans
• Mixed acanthosis nigricans

Other Classifications of Acanthosis nigricans

Acanthosis nigricans may also be divided into the following types:

• Acral Acanthotic Anomaly (Acral Acanthosis Nigricans)
• Acanthosis nigricans type I
• Acanthosis nigricans type II
• Acanthosis nigricans type III

Signs, tests, and misdiagnoses

Physicians can usually diagnose acanthosis nigricans by simply looking at a patient's skin. A skin biopsy may be needed in unusual cases. If no clear cause of acanthosis nigricans is obvious, it may be necessary to search for one. Blood tests, an endoscopy, or x-rays may be required to eliminate the possibility of diabetes or cancer as the cause.

Additionally acanthosis nigricans has similar visual characteristics (neck discoloration) with Casal collar, which is a symptom of pellegra (a nutrient deficiency disease, easily remedied with supplementation). In early stages of discoloration, it is hard for a non trained eye to distinguish one from the other.

Treatment

People with acanthosis nigricans should be screened for diabetes and, although rare, cancer. Controlling blood glucose levels through exercise and diet often improves symptoms. Acanthosis nigricans maligna may resolve if the causative tumor is successfully removed.

Prognosis

Acanthosis nigricans often fades if the underlying cause can be determined and treated appropriately.

References

External links

• [1]
• AOCD
• http://www.skinsight.com/adult/acanthosisNigricans-references.htm
• 00001 at CHORUS

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 黒色表皮腫 acanthosis nigricans
• 2. Acquired hyperpigmentation disorders
• 3. 内臓悪性腫瘍の皮膚症状 cutaneous manifestations of internal malignancy
• 4. フォックス・フォアダイス病（アポクリン汗疹） fox fordyce disease apocrine miliaria
• 5. Congenital and inherited hyperpigmentation disorders

English Journal

• Differing clinical features in Aboriginal vs. non-Aboriginal children presenting with type 2 diabetes.

• Amed S, Hamilton JK, Sellers EA, Panagiotopoulos C, Hadjiyannakis S, Shah BR, Booth GL, Laubscher TA, Dannenbaum D, Dean H.SourceDepartment of Pediatrics, University of British Columbia, Vancouver, BC, V6H 3V4, Canada; BC Children's Hospital, Vancouver, BC, V6H 3V4, Canada.
• Pediatric diabetes.Pediatr Diabetes.2012 Sep;13(6):470-5. doi: 10.1111/j.1399-5448.2012.00859.x. Epub 2012 Feb 27.
• OBJECTIVES: Childhood type 2 diabetes (T2D) is increasing and may present differently across various populations. This study compares clinical features of T2D at diagnosis in Aboriginal children with Caucasian children and children from other high-risk ethnic groups.PATIENTS AND METHODS: This retros
• PMID 22369184

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

• Kudo-Watanuki S, Kurihara E, Yamamoto K, Mukai K, Chen KR.SourceDepartments of Dermatology Diagnostic Pathology, Tokyo-to Saiseikai Central Hospital, Tokyo, Japan.
• Clinical and experimental dermatology.Clin Exp Dermatol.2012 Aug 27. doi: 10.1111/j.1365-2230.2012.04373.x. [Epub ahead of print]
• 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
• PMID 22924529

Japanese Journal

• 症例 胃癌発見の契機となった悪性黒色表皮腫の1例

• 高塚 純子,竹之内 辰也,佐藤 俊大
• 皮膚科の臨床 54(7), 991-994, 2012-07-00
• NAID 40019379588

• 小児期メタボリックシンドローム予防健診における黒色表皮症評価とその問題点

• 山根 慎治,原 光彦,斉藤 恵美子 [他],黒森 由紀,岩田 富士彦,岡田 知雄,麦島 秀雄
• 肥満研究 : 日本肥満学会誌 = Journal of Japan Society for the Study of Obesity 18(1), 33-38, 2012-04-25
• NAID 10030569636

Related Links

• Acanthosis nigricans - Wikipedia, the free encyclopedia

Acanthosis nigricans is a brown to black, poorly defined, velvety hyperpigmentation of the skin. It is usually found in body folds, such as the posterior and lateral folds of the neck, the axilla, groin, umbilicus, forehead, and other areas.

Related Pictures

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★リンクテーブル★

リンク元

「黒色表皮腫」

「黒色表皮腫」

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英

acanthosis nigricans, acanthosis nigricance

同

黒色棘細胞増殖症、黒色表皮肥厚症、黒色表皮症？

関

デルマドローム

[show details]

黒色表皮症 : 約 9,320 件
黒色表皮腫 : 約 22,800 件

分類

NDE.256

• 悪性：悪性腫瘍(胃癌)に伴う
• 良性：内分泌疾患に伴う
• 仮性：肥満に伴う

病理

• 角質増殖、乳頭腫症、真皮乳頭の突出が認められる。

多嚢胞性卵巣症候群との関連

• 多毛を伴う多嚢胞性卵巣症候群患者では高インスリン血症と黒色表皮腫が見られる。(NGY.160)

参考

• 1. 写真

http://www.skinsight.com/adult/acanthosisNigricans.htm

http://www.health32.com/acanthosis-nigricans-treatment-and-prevention/

http://www.acanthosisnigricans.org/

• 2. 黒色表皮腫 - nurs

http://www.nurs.or.jp/~academy/igaku/y/yad.htm

• 3. 写真 良性黒色表皮腫

http://www.dermis.net/dermisroot/ja/34663/image.htm

uptodate

• 1. [charged] 皮膚に影響を及ぼす代謝性および遺伝性疾患 - uptodate [1]
• 2. [charged] 内臓悪性腫瘍の皮膚症状 - uptodate [2]

国試

• 103B046、102A035、099A008