Acanthosis nigricans (AN) is most often associated with obesity and insulin resistance.[2]Schwartz RA. Acanthosis nigricans. J Am Acad Dermatol. 1994 Jul;31(1):1-19.
http://www.ncbi.nlm.nih.gov/pubmed/8021347?tool=bestpractice.com
[5]Brickman WJ, Binns HJ, Jovanovic BD, et al. Acanthosis nigricans: a common finding in overweight youth. Pediatr Dermatol. 2007 Nov-Dec;24(6):601-6.
http://www.ncbi.nlm.nih.gov/pubmed/18035980?tool=bestpractice.com
[6]Kong AS, Williams RL, Rhyne R, et al. Acanthosis nigricans: high prevalence and association with diabetes in a practice-based research network consortium-a PRImary care Multi-Ethnic network (PRIME Net) study. J Am Board Fam Med. 2010 Jul-Aug;23(4):476-85.
https://www.jabfm.org/content/23/4/476
http://www.ncbi.nlm.nih.gov/pubmed/20616290?tool=bestpractice.com
[7]Maguolo A, Maffeis C. Acanthosis nigricans in childhood: a cutaneous marker that should not be underestimated, especially in obese children. Acta Paediatr. 2020 Mar;109(3):481-7.
http://www.ncbi.nlm.nih.gov/pubmed/31560795?tool=bestpractice.com
It is the most common dermatological manifestation of obesity.[15]Yosipovitch G, DeVore A, Dawn A. Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol. 2007 Jun;56(6):901-16.
http://www.ncbi.nlm.nih.gov/pubmed/17504714?tool=bestpractice.com
As rates of obesity rise globally, so does the incidence of AN.[1]Das A, Datta D, Kassir M, et al. Acanthosis nigricans: a review. J Cosmet Dermatol. 2020 Aug;19(8):1857-65.
http://www.ncbi.nlm.nih.gov/pubmed/32516476?tool=bestpractice.com
AN is very common in dark-skinned populations throughout the world, but is rare in white people.[16]Maitra SK, Rowland Payne CM. The obesity syndrome and acanthosis nigricans. J Cosmet Dermatol. 2004;3:202-210. The prevalence of AN varies from 7% to 74%, depending on the type of AN and on patient factors; including age, race, and presence of obesity and associated endocrinopathy.[1]Das A, Datta D, Kassir M, et al. Acanthosis nigricans: a review. J Cosmet Dermatol. 2020 Aug;19(8):1857-65.
http://www.ncbi.nlm.nih.gov/pubmed/32516476?tool=bestpractice.com
A study of 1133 patients in southwest US reported the prevalence of AN as 21% in adults and 17% in children; people with type 2 diabetes mellitus were almost twice as likely to have AN compared with people without diabetes.[17]Kong AS, Williams RL, Smith M, et al. Acanthosis nigricans and diabetes risk factors: prevalence in young persons seen in southwestern US primary care practices. Ann Fam Med. 2007 May-Jun;5(3):202-8.
http://www.annfammed.org/cgi/content/full/5/3/202
http://www.ncbi.nlm.nih.gov/pubmed/17548847?tool=bestpractice.com
Children with AN are up to 4.2 times as likely to have hyperinsulinaemia than those without.[7]Maguolo A, Maffeis C. Acanthosis nigricans in childhood: a cutaneous marker that should not be underestimated, especially in obese children. Acta Paediatr. 2020 Mar;109(3):481-7.
http://www.ncbi.nlm.nih.gov/pubmed/31560795?tool=bestpractice.com
[18]Mukhtar Q, Cleverly G, Voorhees RE, et al. Prevalence of acanthosis nigricans and its association with hyperinsulinemia in New Mexico Adolescents. J Adolesc Health. 2001 May;28(5):372-6.
http://www.ncbi.nlm.nih.gov/pubmed/11336866?tool=bestpractice.com
In one study of 618 young people, AN was found in 62% of people with a BMI >98th percentile and was more common in ethnic minorities, with 23% of Hispanic, 19% of black, and 4% of white people affected.[5]Brickman WJ, Binns HJ, Jovanovic BD, et al. Acanthosis nigricans: a common finding in overweight youth. Pediatr Dermatol. 2007 Nov-Dec;24(6):601-6.
http://www.ncbi.nlm.nih.gov/pubmed/18035980?tool=bestpractice.com
Malignant AN is rare, although the exact incidence is unknown. It is reportedly present in 2 out of 12,000 patients with cancer.[19]Stawczyk-Macieja M, Szczerkowska-Dobosz A, Nowicki R, et al. Malignant acanthosis nigricans, florid cutaneous papillomatosis and tripe palms syndrome associated with gastric adenocarcinoma. Postepy Dermatol Alergol. 2014 Feb;31(1):56-8.
https://www.termedia.pl/Case-report-Malignant-acanthosis-nigricans-florid-cutaneous-papillo-matosis-and-tripe-palms-syndrome-associated-with-gastric-adenocarcinoma,7,22277,1,1.html
http://www.ncbi.nlm.nih.gov/pubmed/24683401?tool=bestpractice.com
It is reported most often in adults over the age of 40 years and has no sex or racial predilection.[8]Moore RL, Devere TS. Epidermal manifestations of internal malignancy. Dermatol Clin. 2008 Jan;26(1):17-29.
http://www.ncbi.nlm.nih.gov/pubmed/18023768?tool=bestpractice.com