Acanthosis nigricans: A review

Anupam Das, Debatri Datta, Martin Kassir, Uwe Wollina, Hassan Galadari, Torello Lotti, Mohammad Jafferany, Stephan Grabbe, Mohamad Goldust

Research output: Contribution to journalReview articlepeer-review

46 Citations (Scopus)


Background: Acanthosis nigricans (AN) is a cutaneous disorder characterized by symmetric velvety hyperpigmented plaques on intertriginous areas like axilla, neck, inframammary, and groin. Aims: To summarize the pathophysiology and classification of AN, provide an update of diagnostic testing strategies, and describe the current therapeutic options described so far in the literature for this disease. Methods: A comprehensive english language literature search across multiple databases (PubMed, EMBASE, MEDLINE, and Cochrane) for keywords (alone and in combination) was performed. MeSH as well as non-MeSH terms such as “acanthosis nigricans,” “classification,” “pathophysiology,” “diagnosis,” “treatment,” “topical drugs,” “systemic drugs,” “chemical peeling,” and “lasers” were taken into consideration. Results: The pathophysiology of AN revolves around a multifactorial stimulation of proliferation of epidermal keratinocytes and dermal fibroblasts. Various types of AN include benign, obesity-associated, syndromic, malignant, acral, unilateral, medication-induced, and mixed-type. Homeostasis model assessment-insulin resistance (HOMA-IR) is a good tool for assessment of insulin resistance. Management involves general measures (weight reduction and addressing the underlying cause, if any), topical drugs (retinoids, vitamin D analogs, and keratolytics), oral drugs (retinoids and insulin sensitizers), chemical peels (trichloroacetic acid), and lasers (Long pulsed alexandrite, fractional 1550-nm erbium fiber, and CO2). Conclusion: Acanthosis nigricans is a treatable condition; however, complete cure and disappearance of lesions are difficult to achieve. Weight reduction is the most scientific and practical management strategy. Long-term studies and further research is warranted in the pathophysiology and treatment of this common condition.

Original languageEnglish
Pages (from-to)1857-1865
Number of pages9
JournalJournal of Cosmetic Dermatology
Issue number8
Publication statusPublished - Aug 1 2020


  • acanthosis nigricans
  • classification
  • diagnosis
  • pathophysiology
  • treatment

ASJC Scopus subject areas

  • Dermatology


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