Acanthosis Nigricans – Diagnosis and Treatment
Diagnosis
Healthcare providers usually check for acanthosis nigricans during a physical exam by looking for dark, thickened, and velvety patches in skin folds—commonly on the neck, armpits, groin, or knuckles.
To identify possible underlying causes, providers may order:
- Blood glucose or hemoglobin A1c tests to evaluate for type 2 diabetes or insulin resistance, which are common triggers.
- Lipid panel to assess cholesterol and triglyceride levels, especially if metabolic syndrome is suspected.
- Thyroid function tests to rule out hypothyroidism or other hormonal imbalances.
- Hormone level testing (such as insulin, cortisol, or androgens) if a hormonal disorder or endocrine issue is suspected.
- Skin biopsy, in rare cases, if the diagnosis is unclear or if there is concern about malignancy or unusual appearance. A small sample is taken and examined under a microscope.
If the condition appears suddenly, spreads quickly, or involves unusual areas, doctors may investigate for underlying cancers, particularly in adults.
This includes ordering imaging studies or additional lab work to rule out internal malignancies, often in the gastrointestinal or genitourinary tract.
Treatment
Doctors mainly target improving skin appearance and reducing discomfort. They may recommend topical creams like retinoids, corticosteroids, or hydroquinone.
These can help lighten dark patches and smooth the skin. Sometimes, doctors use laser therapy for more stubborn areas.
Doctors encourage weight loss and regular exercise if excess weight is a factor. Eating healthy foods might improve results. For some, doctors change medications or stop a specific drug to help.
Other options include Tri-Luma, azelaic acid, or tretinoin creams. Gentle skin care products and special soaps may lower irritation and odor.
Getting Ready for Your Visit
Ways to Prepare
People can gather important information before heading to the doctor. They should make a note of:
- Any family members with similar skin problems
- A family history of diabetes
- Any past issues with their ovaries, adrenal glands, or thyroid
- All medications and supplements they take
- Any past use of high-dose prednisone or other steroids
- Past health procedures such as endoscopy, if relevant
Bringing this list along helps answer questions and saves time during the visit.
Questions the Doctor Might Ask
During the appointment, the doctor may ask questions such as:
| Key Topics | Example Questions |
|---|---|
| Symptom History | When did the skin changes start? |
| Symptom Progression | Have these areas gotten worse over time? |
| Areas Affected | Which parts of your body are showing changes? |
| Personal Medical History | Have you ever had cancer, or major health issues? |
