Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Acanthosis nigricans (AN) is a cutaneous marker strongly associated with underlying insulin resistance and metabolic syndrome Napolitano et al. 2015Karadağ et al. 2018Leung et al. 2022. To investigate a patient with AN for these conditions, the assessment should include a combination of clinical evaluation and laboratory tests, consistent with the approach for assessing comorbidities in overweight and obese patients NICE NG246.
Key investigations include:- Clinical Assessment: This involves measuring the patient's body mass index (BMI) and waist circumference, as well as blood pressure NICE NG246. A thorough medical history should also be taken, including family history of diabetes or cardiovascular disease NICE NG246.
- Laboratory Tests: Essential blood tests include fasting plasma glucose or HbA1c to assess for impaired glucose metabolism or diabetes NICE NG246. A lipid profile, including total cholesterol, HDL cholesterol, and triglycerides, should also be checked to identify dyslipidemia, a component of metabolic syndrome NICE NG246.
While AN is primarily linked to insulin resistance, it is important to note that it can rarely be a paraneoplastic syndrome associated with internal malignancy, though this is less common in the context of assessing for metabolic conditions Leung et al. 2022.
Key References
- NG246 - Overweight and obesity management
- NG17 - Type 1 diabetes in adults: diagnosis and management
- NG12 - Suspected cancer: recognition and referral
- (Napolitano et al., 2015): Insulin resistance and skin diseases.
- (Karadağ et al., 2018): Acanthosis nigricans and the metabolic syndrome.
- (Leung et al., 2022): Acanthosis Nigricans: An Updated Review.