SEARCH · PubMed Health

Results for “ACANTHOSIS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources

PubMed1992

Peripheral glucose metabolism in patients with insulin resistance and acanthosis nigricans.

The present study was designed to determine forearm muscle glucose uptake and oxidation during the postabsorptive state and after an oral glucose challenge in patients with type A insulin resistance and acanthosis nigricans. Nine normal subjects and six acanthotic patients were studied after an overnight fast (12-14 h) and during 3 hours after ingestion of 75 g of glucose. Peripheral glucose metabolism was analysed by the forearm technique to estimate muscle exchange of substrate combined with indirect calorimetry in forearm. Two patients (1 and 6) with insulin resistance and acanthosis nigricans had impaired glucose tolerance. All other patients and normals revealed normal glucose tolerance during the tests. Decreased forearm muscle glucose uptake was observed in patients 1 and 6 compared to normal subjects (6.3 and 51.1 vs 127.7 +/- 10.1 mg/100 ml forearm.3 h, respectively). Decreased forearm muscle glucose oxidation was also observed in patient 1 as well as in patient 3 who showed normal glucose tolerance. Serum FFA levels were elevated in patient 1 but not in patient 3 and in the other acanthotic patients compared to the normal subjects. Serum insulin levels were significantly higher in acanthotic patients than in normals before and after glucose loading. The results of the present study revealed that two of six patients with type A insulin resistance and acanthosis nigricans who exhibited glucose intolerance also showed a decrease in peripheral muscle glucose uptake and nonoxidative glucose metabolism. Another patient (3) with normal glucose tolerance showed impaired muscle glucose oxidation but unaltered muscle glucose uptake and nonoxidative metabolism during the 3 hours of study.(ABSTRACT TRUNCATED AT 250 WORDS)

Acanthosis Nigricans↗

PubMed2004

Vulvar acanthosis with altered differentiation: a precursor to verrucous carcinoma?

Verrucous carcinoma (VC) of the vulva is a rare variant of squamous cell carcinoma (SCC) of the vulva that afflicts older women and is characterized by a well-differentiated morphology with minimal nuclear atypia. The pathogenesis of VC is uncertain and a putative role for human papillomavirus (HPV) is doubtful. We analyzed 9 vulvar VCs from 7 patients diagnosed as VC of the vulva over the past 10 years at Brigham and Women's Hospital and Beth Israel Deaconess Medical Center. The patients ranged from 75 to 93 years in age (median, 83 years). One also involved the vagina and another coexisted with a keratinizing SCC. VC was associated with lichen sclerosus in 1 case; 7 others contained lichen simplex chronicus with verrucous architecture. In 7 cases, a distinctive noninvasive squamous epithelial proliferation, exhibiting a triad of marked acanthosis with variable verruciform architecture, loss of the granular cell layer with superficial epithelial cell pallor, and multilayered parakeratosis. We have designated these changes vulvar acanthosis with altered differentiation. In 5 of the 9 lesions, formalin-fixed, paraffin-embedded material was available for polymerase chain reaction analysis of HPV nucleic acids and all scored HPV negative. In conclusion, VC is a rare HPV-negative neoplasm that may be associated with other HPV-negative SCCs or its precursors, shares similar morphologic risk factors (lichen sclerosus and lichen simplex chronicus), and is frequently associated with an unusual intraepithelial lesion that can be distinguished from both classic and differentiated forms of vulvar intraepithelial neoplasia. The possibility that vulvar acanthosis with altered differentiation is a precursor to, or a risk factor for, vulvar carcinoma, merits further study.

Acanthosis Nigricans↗

PubMed1994

Ophthalmic manifestations of acanthosis nigricans.

A 77-year-old man had fleshy papillomatous lesions on his eyelid margins, which initially were accompanied by lesions on his lips and tongue and plaques on his scrotum, areolae, neck, axillae, and hands. He had had adenocarcinoma of the sigmoid colon and stomach. Based on the clinical findings and histopathologic evaluation of the eyelids (showing papillomatous changes with hyperkeratosis and mild acanthosis), the diagnosis of acanthosis nigricans was made. Acanthosis nigricans may be benign or malignant; in this patient it was malignant. The malignant form is usually of gastrointestinal origin, and in adults may be a marker for an occult malignancy.

Acanthosis Nigricans↗

PubMed1992

Excess insulin binding to insulin-like growth factor receptors: proposed mechanism for acanthosis nigricans.

Clinical and epidemiologic evidence has shown acanthosis nigricans to be closely related to defective tissue utilization of insulin in a number of previously recognized (e.g., obesity, lipodystrophy, and leprechaunism) as well as recently characterized (e.g., type A and type B syndromes) disorders. This article reviews the relationship of acanthosis nigricans to these insulin-resistant states. It also focuses attention on the possibility that interaction between excessive amounts of circulating insulin with insulin-like growth factor receptors on keratinocytes and dermal fibroblasts leads to the development of acanthosis nigricans.

Acanthosis Nigricans↗

PubMed1976

Unilateral epidermal naevus resembling acanthosis nigricans.

A man born with a unilateral epidermal naevus on the right side of the abdomen developed at puberty symmetrical benign acanthosis nigricans in the body folds. The symmetrical eruption later disappeared completely. The unilateral epidermal naevus and the symmetrical eruption showed identical histological features, i.e. those of acanthosis nigricans. At the age of 32 he developed a muco-epidermoid cancer of the left parotid gland. A decision whether the association of unilateral epidermal naevi with malignant tumours occurs with unusual frequency requires (a) a long follow-up of the patient with the unilateral naevus, (b) a differentiation of the unilateral eruption from unilateral malignant acanthosis nigricans and (c) statistical evidence.

Abdomen↗

PubMed1996

Case report: acanthosis nigricans in association with primary biliary cirrhosis: resolution after liver transplantation.

A case is described of a 58 year old Caucasian male with primary biliary cirrhosis (PBC) who first presented with acanthosis nigricans of both axillae, skin pigmentation, which was pronounced over the posterior surface of the neck, and generalized pruritus. Following orthotopic liver transplantation for progressive liver disease, the skin pigmentation, pruritus and acanthosis nigricans resolved. It is believed that this is the first reported case of acanthosis nigricans occurring in association with PBC, a phenomenon that resolved after liver transplantation.

Acanthosis Nigricans↗

PubMed2004

Treatment of Acanthosis nigricans of the axillae using a long-pulsed (5-msec) alexandrite laser.

BACKGROUND: Acanthosis nigricans of the axillae is a common cutaneous disorder that is difficult to treat. OBJECTIVE: The objective was to assess the efficacy and safety of a long-pulsed alexandrite laser (5 msec) in the treatment of acanthosis nigricans of the axillae. METHODS: A single axilla was treated using the long-pulsed alexandrite laser. Ten sessions were required, at fluences of 16 to 23 J/cm2 using either 10- or 12.5-mm spot sizes. The untreated axilla served as a control. RESULTS: Greater than 95% clearance was achieved after seven sessions. There was no recurrence after 2 years. The untreated axilla was unchanged. CONCLUSIONS: The long-pulsed alexandrite laser can effectively and safely treat acanthosis nigricans of the axillae.

Acanthosis Nigricans↗

PubMed1997

Effect of metformin on glucose disposal and hyperinsulinaemia in a 14-year-old boy with acanthosis nigricans.

We report the treatment of a 14-year-old Indian boy with acanthosis nigricans and hyperinsulinaemia with metformin in an attempt to improve his skin lesions. Oral metformin was used for 6 months with assessment of insulin status during an intravenous glucose tolerance test and hyperinsulinaemic-euglycaemic clamping before and after treatment. The first-phase insulin response reduced from 19,593 to 5,410 pmol/l/min (normal 1,900-13,400), and the second-phase insulin response improved from 59,120 to 34,020 pmol/l/min (normal 2,900-18,100). During hyperinsulinaemic-euglycaemic clamping hepatic glucose production was normally suppressed prior to therapy, but peripheral glucose remained abnormally low, 152 and 138% of basal (expected 199%). The acanthosis nigricans remained unaltered but over this period puberty progressed and his body mass index increased. We conclude that, in this patient, metformin had a minimal effect on the hyperinsulinism and none on the acanthosis nigricans in the relatively short term, but further studies in more patients over longer time intervals are warranted.

Acanthosis Nigricans↗

PubMed1981

Generalized acanthosis nigricans.

A patient suffering from an advanced and inoperable gastric carcinoma developed an unusual paraneoplastic syndrome, consisting of intensive pruritus, acanthosis nigricans, sign of Leser-Trélat (seborrhoic keratoses and freckles), warty and papillomatous excrescences, palmoplantar hyperkeratosis and florid papillomatous and granular lesions of the mouth mucosa. The whole skin of the patient was involved. The authors believe this disorder to be generalized acanthosis nigricans. As a cause they suggest the possibility of a growth-stimulating factor, produced by the tumor cells. The relationship of acanthosis nigricans with the sign of Leser-Trélat is discussed.

Acanthosis Nigricans↗

PubMed2006

Acanthosis nigricans following single lung transplantation: a case report.

Acanthosis nigricans was observed 3 months after single lung transplantation in a 51-year-old African American woman with idiopathic pulmonary fibrosis. The patient had no endocrinological abnormalities and was not taking any medications known to cause acanthosis nigricans; extensive investigation did not reveal an underlying malignant process. Because acanthosis nigricans may occur as a paraneoplastic phenomenon, it is important to rule out an underlying malignancy. This is especially important in solid-organ transplant recipients receiving chronic immunosuppressive therapy.

Acanthosis Nigricans↗

PubMed1978

Insulin resistance, acanthosis nigricans, and normal insulin receptors in a young woman: evidence for a postreceptor defect.

We have previously described a group of young females with virilization, acanthosis nigricans, insulin resistance, and markedly decreased binding of insulin to its receptor (syndrome of insulin resistance and acanthosis nigricans type A). The present report concerns a 15-yr-old female with clinical features indistinguishable from the type A patients, including virilization, acanthosis nigricans, and extreme resistance to endogenous and exogenous insulin. Insulin levels were 400-650 microU/ml while fasting and were over 2200 microU/ml when stimulated. Proinsulin was less than 10% of the total immunoassayable insulin. In distinct contrast to the type A patients, insulin receptors on cells from this patient were entirely normal on the basis of specificity, negative cooperativity, affinity, concentration, and interaction with antiinsulin receptor antibodies. These findings suggest the presence of an intracellular defect as the cause of the observed insulin resistance.

Acanthosis Nigricans↗

PubMed1987

The effects of hyperinsulinemia on serum testosterone, progesterone, dehydroepiandrosterone sulfate, and cortisol levels in normal women and in a woman with hyperandrogenism, insulin resistance, and acanthosis nigricans.

Insulin may mediate the hyperandrogenism that frequently occurs in patients with insulin-resistant states. To test this hypothesis, we studied five normal women and one woman with hyperandrogenism, insulin resistance, and acanthosis nigricans with the hyperinsulinemic-euglycemic clamp technique. Each woman received a 0.1 U/kg insulin bolus dose, followed by a 10 mU/kg X min insulin infusion for 12-16 h. In the normal women, an average insulin level of 1832 +/- 292 (+/- SEM) microU/ml was achieved; serum glucose was clamped at 116 +/- 5 mg/dl. At this level, insulin may bind to the insulin-like growth factor I receptor as well as to its own receptor. Contrary to our working hypothesis, a rise in serum testosterone did not occur in any women during insulin infusion, and in one women, serum testosterone levels decreased. When analyzed as a percentage of the basal value, serum progesterone levels fell 20% in the normal women within the first 2 h of insulin infusion, but did not change thereafter. Dehydroepiandrosterone sulfate (DHEA-S) levels, however, uniformly and progressively decreased by 39% after 12 h of insulin infusion in the normal women and by 31% at 14 h in the woman with hyperandrogenism, insulin resistance, and acanthosis nigricans. The fall in serum DHEA-S levels was not due to diurnal rhythmicity, as the changes in serum DHEA-S levels did not correlated with those in serum cortisol. Suppression of PRL release also was excluded as a cause of the fall in DHEA-S levels. These results indicate that acute hyperinsulinemia of 12- to 16-h duration does not increase serum testosterone or DHEA-S concentrations and, indeed, can cause a decline in serum DHEA-S levels in both normal women and the single woman studied with hyperandrogenism, insulin resistance, and acanthosis nigricans.

Acanthosis Nigricans↗

PubMed1993

Acromegaly with polycystic ovaries, hyperandrogenism, hirsutism, insulin resistance and acanthosis nigricans: a case report.

We describe a woman with acromegaly who had acanthosis nigricans and hirsutism. Serum growth hormone (GH) and testosterone levels were markedly elevated. Standard oral glucose tolerance test (OGTT) showed a diabetic curve and no suppressed GH levels. Fasting insulin levels were very high while plasma glucose levels were not hypoglycemic. Insulin tolerance test revealed blunted hypoglycemic response. Acanthosis nigricans was present in the right axilla and face. Ultrasonogram demonstrated bilateral polycystic changes in the ovaries. From the above findings this patient's condition is characteristic of a very rare syndrome consisting of acromegaly, polycystic ovaries (PCO), hyperandrogenism, hirsutism, insulin resistance and acanthosis nigricans.

Acanthosis Nigricans↗

PubMed2001

Cohen syndrome with acanthosis nigricans and insulin resistance.

Cohen syndrome is a rare genetic disorder consisting of truncal obesity, hypotonia, mental retardation, microcephalia, characteristic facial appearance and ocular anomalies. Other diagnostic clinical features include narrow hands and feet, low growth parameters, neutropenia and chorioretinal dystrophy. Acanthosis nigricans is a cutaneous disorder characterized by hyperpigmentation and papillomatosis. Syndromal acanthosis nigricans may occasionally appear as a feature of several specific syndromes. We report a patient showing the typical characteristics of Cohen syndrome with acanthosis nigricans and hyperinsulinemia.

Acanthosis Nigricans↗

PubMedDate not supplied

Ovarian activity before and after gonadal suppression by GnRH-a in patients with polycystic ovary syndrome, hyperandrogenism, hyperinsulinism and acanthosis nigricans.

OBJECTIVE: To investigate the ovarian activity before and after gonadal suppression with GnRH-analog in patients with PCO, hyperandrogenism, hyperinsulinism and acanthosis nigricans. DESIGN: Controlled clinical study. SETTING: Tertiary academic medical center. PATIENTS: Six patients with clinical findings of PCO, hirsutism and acanthosis nigricans. INTERVENTIONS: Morning blood samples in the follicular phase to determine the steroid levels, glucose and insulin curve, comparing to a control group. Administration for 2 consecutive months of a GnRH-analog, comparing, in the study group, the free testosterone levels before and after ovarian suppression. MAIN OUTCOME MEASURE: Determination of insulin levels in PCO, hirsutism and acanthotic patients and the free-testosterone levels before and after gonadal suppression. RESULTS: Insulin levels were significantly higher in the study group when compared to normal women during the glycemic test. We also found a significant decrease in the free-testosterone levels after 2 months of gonadal suppression with GnRH-analog when compared to the initial time. CONCLUSIONS: Patients with PCO, hirsutism and acanthosis nigricans present high levels of insulin, suggesting an ovarian hyperesponsiveness, which is not sustained when gonadotrophic blockage was achieved.

Acanthosis Nigricans↗

PubMed2000

Crouzon syndrome with acanthosis nigricans: case report and mutational analysis.

OBJECTIVE: To describe the 22nd case of Crouzan syndrome with acanthosis nigricans, a hyperkeratotic skin disorder with hyperpigmentation. METHODS: DNA analysis and sequencing of the FGFR3 gene were performed. RESULTS: The 13-year-old Japanese boy described here also had dyspnea, facial palsy, sensorineural hearing loss, and skeletal and mental retardation. Examination of a skin biopsy specimen revealed the typical findings of acanthosis nigricans. Genetic analysis revealed the Ala391Glu mutation in one FGFR3 gene. CONCLUSIONS: Crouzon syndrome with acanthosis nigricans is a distinct clinical entity different from classic Crouzon syndrome.

Acanthosis Nigricans↗

PubMed2004

Acanthosis nigricans associated with insulin resistance : pathophysiology and management.

The association of acanthosis nigricans, skin tags, diabetes mellitus due to insulin resistance, and obesity in adolescents and young adults represents a well defined syndrome. Hyperandrogenism may also be present. The endocrine origin of this condition is beyond doubt. Insulin and insulin-like growth factor-1, and their receptors on keratinocytes are obviously involved in the complex regulations leading to the peculiar epidermal hyperplasia. This condition is unrelated to other types of acanthosis nigricans, including the congenital and the paraneoplastic types. Control of obesity contributes largely to reverse the whole process, essentially by reducing both insulin resistance and compensatory hyperinsulinemia. Several drugs including metformin, octreotide, retinoids and topical colecalciferol (vitamin D(3)) analogs are also beneficial in clearing acanthosis nigricans.

Acanthosis Nigricans↗

PubMed1996

Generalised acanthosis nigricans with vitiligo.

We report on a 19-year-old woman with generalised acanthosis nigricans of the inherited type and concomitant vitiligo. Cutaneous velvety thickening of the skin with intensification of skin markings and progressive development of hyperpigmented papillomatous, verrucoid lesions in the body folds started to develop in early childhood. These hyperpigmentations were continuously replaced by a progressive vitiligo, finally leaving most of the acanthosis nigricans lesions completely depigmented. Generalised, pachyderma-like acanthosis nigricans with concomitant vitiligo is an association which to the best of our knowledge has not yet been described.

Acanthosis Nigricans↗