Acanthosis Nigricans and Associated Metabolic Disorders

Acanthosis nigricans is a dermatological condition characterised by hyperpigmented, velvety plaques typically affecting intertriginous areas such as the neck, axillae and knuckles. Although benign forms often arise in association with obesity and hyperinsulinaemia, a rarer malignant variant may herald internal malignancy. The benign form reflects insulin resistance driving keratinocyte and dermal fibroblast proliferation via increased insulin-like growth factor signalling. This cutaneous sign has emerged as a valuable non-invasive marker of underlying metabolic disturbance, correlating strongly with obesity, type 2 diabetes mellitus, metabolic syndrome and polycystic ovary syndrome. In paediatric and adult cohorts alike, its presence facilitates early identification of high-risk individuals, enabling timely lifestyle or pharmacological intervention. As global obesity rates continue to climb, recognition of acanthosis nigricans assumes growing public health importance, offering a low-cost screening tool for cardiometabolic risk in primary care and school settings. Management focuses on addressing the underlying metabolic derangement, with weight reduction, insulin-sensitising agents and, when indicated, topical therapies to ameliorate skin appearance.

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Acanthosis Nigricans and Associated Metabolic Disorders publication trend

The graph below shows the total number of articles in acanthosis nigricans and associated metabolic disorders across all publications each year (not limited to Nature Index journals).

Technical terms

Acanthosis nigricans: A cutaneous condition marked by dark, velvety thickening of the skin in body folds, signalling underlying metabolic or neoplastic processes.

Insulin resistance: A physiological state in which cells fail to respond adequately to insulin, leading to compensatory hyperinsulinaemia and disturbed glucose homeostasis.

Metabolic syndrome: A cluster of risk factors—including central obesity, dyslipidaemia, hypertension and impaired glucose tolerance—that together heighten the risk of cardiovascular disease and diabetes.

HOMA-IR (Homeostasis Model Assessment of Insulin Resistance): A calculated index derived from fasting insulin and glucose levels, used to estimate insulin resistance.

References

1. Malignant acanthosis nigricans: an early diagnostic clue for gastric adenocarcinoma. World Journal of Surgical Oncology (2017).
2. Acanthosis nigricans in type 2 diabetes: prevalence, correlates and potential as a simple clinical screening tool - a cross-sectional study in the Caribbean. Diabetology & Metabolic Syndrome (2014).
3. Acanthosis Nigricans: Pointer of Endocrine Entities. Diagnostics (2022).
4. Acanthosis nigricans as a composite marker of cardiometabolic risk and its complex association with obesity and insulin resistance in Mexican American children. PLOS ONE (2020).
5. Severe Quantitative Scale of Acanthosis Nigricans in Neck is Associated with Abdominal Obesity, HOMA‐IR, and Hyperlipidemia in Obese Children from Mexico City: A Cross‐Sectional Study. Dermatology Research and Practice (2022).