calcipotriene and Acanthosis-Nigricans

Acanthosis nigricans is a dermatosis characterized by thickened, hyperpigmented plaques, typically of the intertriginous surfaces and neck. Common in some populations, its prevalence depends on race. Clinicians should recognize acanthosis nigricans; it heralds disorders ranging from endocrinologic disturbances to malignancy. In this review, we discuss the pathogenesis of acanthosis nigricans and its clinical implications and management.

Topics: Acanthosis Nigricans; Adolescent; Calcitriol; Child; Disease Susceptibility; Ethnicity; Female; Fish Oils; Humans; Hypoglycemic Agents; Insulin Resistance; Insulin-Like Growth Factor I; Low-Level Light Therapy; Male; Neoplasms; Prevalence; Receptor Protein-Tyrosine Kinases; Retinoids

Hyperkeratosis of the nipple and areola is a rare disorder characterized by verrucous thickening and brown pigmentation of the nipple and areola with unknown etiology. Although it is a generally asymptomatic disorder, cosmetic disfiguring creates a real psychological problem for young women. Moreover, treatment regimens are not satisfactory. Surgical treatment has been suggested as an initial treatment in resistant and recurrent cases because of the relapses seen after medical treatment. We report a case who responded satisfactorily to low-dose acitretin and topical calcipotriol treatment with no relapses during 2 years of follow-up. Among all reported medical treatments and interventional approaches, including surgery, this is the first patient reported with 2 years of remission.

Topics: Acanthosis Nigricans; Acitretin; Administration, Cutaneous; Adolescent; Breast Diseases; Calcitriol; Dermatologic Agents; Drug Therapy, Combination; Female; Humans; Keratolytic Agents; Keratosis; Nipples; Treatment Outcome

Acanthosis nigricans is a mucocutaneous dermatosis characterized by hyperpigmentation and a velvety papillomatous hyperkeratosis. It is frequently associated with systemic diseases including malignancy and endocrinal disorders. We report the beneficial effect of topical calcipotriol ointment 50 mcg/g twice a day in acanthosis nigricans associated with primary hypogonadism.

Topics: Acanthosis Nigricans; Administration, Cutaneous; Aged; Calcitriol; Dermatologic Agents; Humans; Hypogonadism; Male; Treatment Outcome

To evaluate the literature to determine which oral and topical medications are most effective in the treatment of insulin resistance obesity-related acanthosis nigricans (IRORAN).. A MEDLINE literature search was conducted (1950-January 2008) using the search terms acanthosis nigricans (AN), metformin, rosiglitazone, octreotide, retinoic acid, acitretin, etretinate, and isotretinoin. The search was limited to articles on treatment of IRORAN in humans written in the English language. Articles were retrieved and all references were reviewed.. Articles selected for inclusion were limited to AN related to obesity with no other underlying etiology. Clinical trials and case reports using monotherapy were included.. Metformin, rosiglitazone, octreotide, vitamin D analogs, and retinoic acid have been used in the treatment of IRORAN. In one randomized trial, metformin 500 mg 3 times daily was compared with rosiglitazone 4 mg once daily. Neither treatment demonstrated significant improvements in AN; however, rosiglitazone did significantly decrease serum insulin levels. In a second clinical trial and in several case reports, AN and hyperinsulinemia did show improvement with metformin treatment. After a 6-month period, octreotide improved IRORAN, body weight, and glucose/insulin response to a meal. The improvements persisted for 6 additional months after discontinuation of octreotide. Vitamin D analogs and retinoids produced inconsistent results in 5 separate case reports.. IRORAN is a growing problem, particularly in children and adolescents, secondary to the increase in the prevalence of obesity. Treatment of IRONAN should focus on reversal of the underlying hyperinsulinemia. Patients with IRORAN may benefit from a trial of metformin for improvement of lesions and underlying hyperinsulinemia.

Topics: Acanthosis Nigricans; Adolescent; Adult; Calcitriol; Humans; Hyperinsulinism; Hypoglycemic Agents; Insulin Resistance; Metformin; Obesity; Octreotide; Retinoids; Rosiglitazone; Thiazolidinediones; Vitamin D

Topics: Acanthosis Nigricans; Administration, Topical; Adult; Calcitriol; Dermatologic Agents; Female; Humans; Keratosis; Nipples

Acanthosis nigricans is a hyperkeratotic mucocutaneous eruption of heterogenous etiology which is characterized by hyperpigmentation, velvety cutaneous thickening, intensified skin markings and development of verrucous excrescences typically involving the intertriginous areas. Malignant acanthosis nigricans is most often associated with an abdominal adenocarcinoma frequently unresectable at the time of diagnosis. We report on the rare association of acanthosis nigricans with a transitional cell carcinoma of the urinary bladder. Symptomatic treatment with topical calcipotriol significantly reduced the hyperkeratotic and papillomatous skin changes.

Topics: Acanthosis Nigricans; Administration, Topical; Antineoplastic Agents; Calcitriol; Carcinoma, Transitional Cell; Humans; Male; Middle Aged; Paraneoplastic Syndromes; Skin; Treatment Outcome; Urinary Bladder Neoplasms

Topics: Acanthosis Nigricans; Calcitriol; Dermatologic Agents; Humans; Male; Middle Aged