oa Journal of Endocrinology, Metabolism and Diabetes in South Africa - Editorial
Most clinicians are familiar with acanthosis nigricans, a dermatosis, characterised by brownish-black velvety, papilomatous hyperkeratotic plaques, usually occurring in the neck, axillae and other intertriginous surfaces. Acanthosis nigricans is most frequently associated with insulin-resistant states, such as type 2 diabetes, polycystic ovarian disease and a variety of endocrine disorders. Less commonly, acanthosis nigricans is also associated with internal malignancies, such as carcinoma of the colon, and in the setting of niacin use, in the management of dyslipidaemia. Acanthosis nigricans is detectable in more than 50% of children with type 2 diabetes mellitus, and is recognised more frequently in darker-skinned obese individuals. In this issue of JEMDSA, Venkatswami reports that the severity of acanthosis nigricans correlated with the degree of insulin resistance in a large group of Indian patients attending a dermatology clinic, and also with the texture of the lesions. Lesions that were rough to the touch or visibly coarse also correlated with the degree of insulin resistance, determined with homeostasis model assessment. Thus, acanthosis nigricans may be a useful sign when attempting to detect individuals at high risk of developing type 2 diabetes. It may be worthwhile investigating this finding in the South African context, especially in overweight and obese children and adolescents.
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