Acanthosis nigricans – what is it and why we need to be aware of it? A sign of cancer and diabetes!

Acanthosis nigricans is the medical term for darkened, thickened patches of skin that usually develop in the armpit and around the groin and neck.

Acanthosis nigricans
Acanthosis nigricans

It’s not a condition in itself, but can be a sign of an underlying health problem. These underlying conditions aren’t usually serious, although occasionally acanthosis nigricans can be sign of cancer.

Signs and symptoms

Dark, velvety patches.  If you have acanthosis nigricans, you’ll have thickened, brownish-grey or black patches of skin.

The patches will be dry and rough, feeling similar to velvet. They may also be itchy.

These patches may occur anywhere, but are usually seen around the neck, in the armpit, around the groin and sometimes in other skin folds. Occasionally, the skin over the joints of the fingers and toes may be affected, as well as the lips, palms of the hands and soles of the feet.

The patches usually develop slowly over time. Patches that grow and spread quickly are more likely to be associated with cancer. In these cases, the mouth, tongue, throat, nose and windpipe may also be affected.

Tiny growths on the skin

You may also have lots of tiny finger-like growths from the patches. This is known as papillomatosis.

There may also be skin tags around the affected area. These are small flesh-coloured or pigmented growths that hang off the skin and look a bit like warts.

When to see your GP

Acanthosis nigricans is usually harmless, but as it can be a sign of something serious it’s a good idea to see your GP if you think you have it. They may suspect acanthosis nigricans just by looking at your skin.


If the cause isn’t clear, you may have blood tests to check your blood sugar or hormone levels, and you might need additional tests such as an endoscopy or X-ray.

What causes acanthosis nigricans?

Acanthosis nigricans sometimes occurs in people who are otherwise in good health, particularly dark-skinned people of African descent.

However, in most cases it’s a sign of an underlying problem or condition such as obesity, diabetes or abnormal hormone levels. Some of the main causes of acanthosis nigricans are outlined below.

Obesity

Acanthosis nigricans is usually the result of obesity. This is known as obesity-associated acanthosis nigricans.

It occurs because obesity can cause insulin resistance (when the body is unable to properly use the hormone insulin), which may lead to high levels of insulin in the blood, affecting the skin cells.

Insulin resistance can also cause type 2 diabetes, so acanthosis nigricans can be an early sign that you have diabetes or are at risk of developing the condition.

Syndromes and hormone problems

Acanthosis nigricans is sometimes associated with an underlying syndrome or hormone problem, such as:

This type of acanthosis nigricans is known as syndromic acanthosis nigricans.

Genes

In rare cases, acanthosis nigricans can be caused by a faulty gene inherited directly from your parents. This is known as familial or benign genetic acanthosis nigricans.

This type is usually passed on in an autosomal dominant pattern, which means it can be passed on if only one of your parents carries the faulty gene.

Cancer

If the dark skin patches come on suddenly and spread quickly, it may be a sign you have cancer (usually stomach cancer). This is known as malignant acanthosis nigricans.

This is a rare condition that tends to affect middle-aged or elderly people, regardless of their weight or ethnic background.

The patches are more severe and the mouth, tongue and lips may also be affected. The skin may also become irritated and itchy.

How acanthosis nigricans is treated

Treatment for acanthosis nigricans aims to correct the underlying cause of your symptoms. This will usually cure the acanthosis nigricans or significantly improve the appearance of your skin.

Treatments that may be recommended include:

There’s no specific treatment to get rid of the patches, but a dermatologist (skin specialist) may be able to recommend treatments such as creams or tablets that may help improve the look of your skin.

Outlook

Most cases of acanthosis nigricans are harmless and not a sign of anything serious. The skin patches often fade with time as the underlying condition is treated.

If you have inherited acanthosis nigricans from your parents, your patches may gradually get bigger before staying the same or eventually fading on their own.

Only in cases where there is underlying cancer is the situation very serious. If the tumour is successfully treated, the condition may disappear, but unfortunately the types of cancer that cause acanthosis nigricans tend to spread quickly and a cure is often not possible.

[Original article on NHS Choices website]

Ehlers-Danlos syndrome. What are the signs and symptoms of Ehlers-Danlos syndrome?

Ehlers-Danlos syndrome.
Ehlers-Danlos syndrome.

Welcome to the latest in our series of informational blogs looking at healthcare in general and specific medical conditions in particular.  Today we are focussing our attention on a genetic condition called Ehlers-Danlos syndrome.

Affecting around 1 in 5,000 people, Ehlers-Danlos syndrome (or EDS) causes your collagen production to be lower than in the average person.  Collagen is a protein the main function of which is to strengthen various body tissues such as blood vessels, skin and bone.

So, typically, a person with EDS will suffer from symptoms such as:-

a)  Loose or sagging skin.  This means that the skin can split more easily.

b) Hypermobility or loose joints. Therefore your joints move more than in an average person without EDS.  Children may take longer to begin to walk with EDS because of certain floppiness.

c)  Vascular problems.  This can lead to bursting organs which may be fatal.  While rare it is the most serious symptom of EDS.

d)Fragile body tissue.  This causes people with EDS to be more likely to have overstretched or even broken ligaments.

e) Pain.  In some cases people with EDS will suffer from limb or joint pain.

As with all our blog posts we are really interested in feedback from our readers especially those who have Ehlers-Danlos syndrome.  It would be really useful to get an overview of life with Ehlers-Danlos syndrome.  This is useful for other people with Ehlers-Danlos syndrome but also parents of children who have just been diagnosed with Ehlers-Danlos syndrome.

A few issues about the condition that struck me as worth mentioning, were pointed out to me by a person with Ehlers-Danlos syndrome whom I spoke with about EDS.  She explained to me exercise is important in building up strength and she recommended swimming.  You may find a previous article we wrote on low impact exercise of interest – http://patienttalk.org/exercise-for-people-with-chronic-pain/.

She also mentioned that children with Ehlers-Danlos syndrome will often wear pads to product themselves during play sessions.

In terms of lifestyle and work activities like hard manual labor are not really possible.   As there is a high probability of fatigue, good rest and sleep patterns are considered important.

So over to you!  It would be great if people with Ehlers-Danlos syndrome could share their experiences to help us raise knowledge and awareness of this genetic condition.   If you could share your answers to the following questions that would be really helpful:-

1)At what age were you diagnosed with Ehlers-Danlos syndrome?

2)What have been your main symptoms?

3)What treatments for Ehlers-Danlos syndrome have you used?  How effective were they?

4)What impact has Ehlers-Danlos syndrome had upon your lifestyle?

5)Where did you go for support and information about Ehlers-Danlos syndrome?

6)What one piece of advice would you give to somebody who has just been diagnosed with Ehlers-Danlos syndrome? (Or indeed the parent of a child just diagnosed with Ehlers-Danlos syndrome!)

Obviously this is just a guide – so please share anything that may be of interest to other readers.  In particular links to any organisations, blogs or online groups would be very gratefully received.

Many thanks in advance.