Acanthosis Nigricans: A Clinicoepidemiological and Therapeutic comparison study

Acanthosis nigricans is characterized by velvety, brownish black pigmentation of flexural areas. Acanthosis nigricans is considered as a marker of internal diseases like insulin resistance, diabetes, hypothyroidism, polycystic ovarian disease and rarely internal malignancies. AIMS AND OBJECTIVES The study aims to 1) Study the epidemiology of Acanthosis Nigricans 2) Find out associated common endocrinological diseases 3) Compare the effectiveness of various topical therapeutic modalities MATERIALS AND METHODS Hundred patients of acanthosis nigricans were selected. Relevant investigations like blood sugar, fasting lipid profile, thyroid profile and ultrasound abdomen were done. Body mass index was calculated for all patients. Patients were then randomly divided into 5 treatment groups of 20 patients each. Group A receiving Topical 0.05% tretinoin, Group B receiving topical 0.005% calcipotriol, Group C receiving topical triple combination cream containing Hydroquinone 2%, tretinoin 0.05% and Fluocinolone acetonide 0.01%, Group D treated with 35% Trichloroacetic acid peel and Group E treated with 50% Glycolic acid peel. OBSERVATION AND RESULTS Acanthosis nigricans was more common in females than males with a ratio of 2.22: 1 and the mean age was 22.24 years. Nearly seventy percent of patients had abnormal body mass index. Acrochordon was the most common associated dermatological finding. Diabetes was the most common endocrine abnormality present in 41% of patients followed by dyslipidemia and hypothyroidism. Nearly 19% of the female patients had polycystic ovarian disease. Chemical peeling with trichloro acetic acid had the maximum response percentage of 75% and topical calcipotriol had the least response percentage of 25%. CONCLUSION In our study age, sex and site distribution were in concurrence with the previous studies. Topical treatment need to be given for longer period with simultaneous treatment of endocrine disorders and obesity for better results