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PubMed1965

CUTANEOUS LESIONS ASSOCIATED WITH INTERNAL MALIGNANCY.

Internal malignant tumours may stimulate the formation of tumour antigens which, by means of an antigen-antibody mechanism, can cause pruritus, ichthyosis, erythroderma, acanthosis nigricans, dermatomyositis, erythema-urticarial and vesiculo-bullous skin eruptions.Tumours may also interfere with normal immunity responses and allow various localized skin eruptions such as herpes zoster and epidermophytoses to escape their normal boundaries and become generalized.Skin malignancies may also be a sign of decreased immunoallergic response and by their presence alert the physician to search for an internal malignancy, either one associated with the skin lesion, such as a lymphoma, or an unrelated tumour.

Acanthosis Nigricans↗
PubMed1992

[A case of insulin receptor abnormality (type A)].

A sixteen year old woman came to the hospital for glucosuria and amenorrhea. Physical examination demonstrated that she had hirsutism, deepening of voice, and pigmented skin in her axillary lesion which was histologically diagnosed as acanthosis nigricans. Ultrasonography showed polycystic ovaries. A diabetic pattern of 75 g oral glucose tolerance test, very high levels of serum insulin (fasting: 320, peak: 1,220 microU/ml), and hyperandrogenism characterized by increases of urine 17-KS, serum testosterone and DHEA-S were found. Both serum insulin and insulin-receptor antibodies were found to be negative. Insulin binding to both erythrocytes and cultured skin fibroblasts were significantly decreased (about 30% of normal controls). Scatchard plot analysis demonstrated decreased number of insulin receptors to about 30% of the normal controls. We therefore diagnosed that she had insulin receptor abnormality, Type A in Kahn's classification.

Acanthosis Nigricans↗
PubMed1978

Florid cutaneous papillomatosis.

The abrupt onset of acanthosis nigricans (AN) or of multiple seborrheic keratoses in middle-aged or older people is often associated with underlying malignant neoplasms. We describe a 64-year-old woman who developed a large number of verrucous papillomas on the trunk and extremities, followed within a few months by the sudden appearance of both the lesions of AN and those of multiple seborrheic keratoses. Laparotomy disclosed a gastric adenocarcinoma. A number of similar cases have been described in the literature. It is emphasized that patients with suddenly appearing verrucous papillomas should be examined carefully for an underlying cancer. To call attention to this eruption, which may be mistaken for generalized warts, we suggest the term "florid cutaneous papillomatosis".

Acanthosis Nigricans↗
PubMed2005

Rabson-Mendenhall syndrome.

Rabson-Mendenhall syndrome is characterized by growth retardation, dysmorphisms, lack of subcutaneous fat, acanthosis nigricans, enlarged genitalia, hirsutism, premature and dysplastic dentition, coarse facial features, paradoxical fasting hypoglycemia and post-prandial hyperglycemia, extreme hyperinsulinemia and pineal hyperplasia. We describe a six-month-old female child with physical features suggestive of the Rabson-Mendenhall syndrome. The child also had medullary nephrocalcinosis.

Abnormalities, Multiple↗
PubMedDate not supplied

Metabolic disorders in children and adolescents with type 2 diabetes mellitus.

BACKGROUND: Type 2 diabetes mellitus (T2DM) in children and adolescents is increasing in incidence worldwide. It is the leading type of newly diagnosed diabetes in Taiwan among school children. T2DM is associated with metabolic syndrome in adults, so we tried to find out if these metabolic disorders are present in children. METHODS: From 1989 to 2003, 22 children and adolescents were diagnosed with T2DM in our hospital. Their ages ranged from 8.8 to 17.0 (11.7+/-2.3) years; 6 of them were boys. We compared their clinical characteristics with those of 42 healthy and 237 obese children and adolescents. Physical examination was performed and plasma glucose and serum cholesterol, triglycerides, uric acid, creatinine, HDL-cholesterol, and insulin levels were measured and LDL-cholesterol was calculated. Demographic and laboratory data were compared among the T2DM, obese and control groups. RESULTS: The female: male ratio among the patients was 2.7: 1; 18% were overweight and 68% obese, and 64% had acanthosis nigricans. There were no significant differences between the T2DM and obese groups in terms of biochemistry profiles except for the higher plasma glucose in the T2DM group. Children with T2DM had higher levels of cholesterol and triglycerides but lower levels of HDL-cholesterol compared with healthy children. Among obese children without T2DM, the levels of glucose, triglycerides, uric acid, insulin, HOMA-IR were higher than in the healthy group, and HDL-cholesterol levels were lower. CONCLUSIONS: Children with T2DM or obesity should be evaluated for metabolic disorders.

Acanthosis Nigricans↗
PubMed1991

Hyperandrogenism: new insights into diagnosis and therapy.

Many different disease processes can result in a phenotype of hirsutism, anovulation, and oligomenorrhea or amenorrhea. An important goal of reproductive endocrinologists is to identify specific genetic diseases that can produce the hyperandrogenic phenotype. Two genetic disorders that can result in the hyperandrogenic phenotype are 1) mutations in the 21-hydroxylase gene (adrenal hyperplasia), and 2) mutations in the insulin receptor gene (the syndrome of hyperandrogenism-insulin resistance and acanthosis nigricans). The identification of these two genetic causes of hyperandrogenism provides the opportunity to investigate new approaches to prenatal diagnosis and therapy, genetic analysis of pedigrees, and innovative forms of therapy.

Acanthosis Nigricans↗
PubMed1991

[Skin manifestation of internal malignancy].

Relationship between malignant tumor of the internal organ and the skin can be classified as skin metastasis of the malignant tumor, non-specific skin manifestation of the malignant tumor and hereditary syndrome which tends to have malignant tumor. I, however, discuss here mainly about the non-specific manifestation of the malignant tumor by showing representative cases of the dermadrome. Such cases are acanthosis nigricans, Leser-Trélat's sign, dermatomyositis, atypical erythema, acquired ichthyosis, Sweet's disease, Weber-Christian's syndrome, phlebitis migrans and Bazex syndrome.

Acanthosis Nigricans↗
PubMed1989

Clinical and endocrine profiles of 62 Malaysian women with polycystic ovary syndrome.

62 cases of polycystic ovary syndrome (PCO) were reviewed with regards to their clinical and endocrine features. The subgroup of patients with acanthosis nigricans (AN) was further studied in detail. The prevalence of the syndrome was significantly higher in the Indian (35.5% of cases). Obesity, AN, hirsutism, non-insulin dependent diabetes mellitus (NIDDM) and raised level of serum testosterone were present in 77.1%, 74%, 79%, 21% and 48% of the cases respectively. Patients with AN was associated with higher body mass index, serum testosterone level, and prevalence of hirsutism and NIDDM than patients without AN. These observations are in keeping with the hypothesis that hyperinsulinemia may be of importance in the pathogenesis of a sub-group of PCO associated with insulin resistant states.

Acanthosis Nigricans↗
PubMed1979

Confluent and reticulated papillomatosis (Gougerot-Carteaud).

Seven cases, one female and six males with confluent and reticulated papillomatosis are presented. Age range was 13-25 years and the skin disease had lasted for 6 months to 3 years. Initially, acanthosis nigricans was suspected in all cases as the skin histology was compatible with that diagnosis. Pityrosporum orbiculare was cultured in 4 cases, but treatment with selenium sulfide and miconazole was unsuccessfull. No endocrinological abnormities were revealed. Only associated feature was a marked xeroderma. The importance of the awareness of the disease is stressed.

Acanthosis Nigricans↗
PubMed1988

Hyperinsulinemia and ovarian hyperandrogenism. Cause and effect.

The evidence that supports the hypothesis that hyperinsulinemia causes ovarian hyperandrogenism was reviewed. The most dramatic clinical expression of the association between hyperinsulinemia and hyperandrogenism is the HAIR-AN syndrome. In the HAIR-AN syndrome, severe insulin resistance results in a compensatory hyperinsulinemia that stimulates ovarian androgen production. Acanthosis nigricans, a dermatologic manifestation of severe insulin resistance, is an epiphenomenon of the disease. Hyperandrogenic (HA) women can be divided into two major groups: insulin-resistant (HA-IR) and non-insulin-resistant (HA-nIR). HA-nIR women have markedly elevated LH, often have minimally elevated serum prolactin, and have polycystic ovaries. HA-IR women have minimally elevated LH, markedly elevated plasma insulin, and stromal hyperthecosis. Women with HA-nIR probably have a primary hypothalamic-pituitary abnormality as the cause of their hyperandrogenism. Women with HA-IR probably have a primary metabolic abnormality as the cause of their hyperandrogenism. The relationship between hyperinsulinemia and hyperandrogenism is one example of the complex interrelationships that exist between central metabolism and reproduction.

Acanthosis Nigricans↗
PubMed1987

Reevaluation of the evidence that an antibody to the insulin receptor is insulinmimetic without activating the protein tyrosine kinase activity of the receptor.

The immunoglobulin fraction of a polyclonal anti-insulin receptor antibody (B-10) derived from a patient with severe insulin resistance and acanthosis nigricans was tested for its ability to activate the protein kinase activity of the insulin receptor and to mimic insulin action in Chinese hamster ovary cells expressing either wild type or kinase-deficient human insulin receptors. This antiserum had previously been reported to be insulinmimetic without activating the insulin receptor protein tyrosine kinase. Antibody B-10 bound to both wild type and mutant human insulin receptors, but it induced receptor down-regulation and stimulated hexose transport and thymidine incorporation into DNA only in cells expressing the wild type receptor. Furthermore, this antibody activated the kinase activity of the wild type insulin receptor in intact cells and in vitro. It is likely, therefore, that the biological activities of antibody B-10, like those of insulin, depend upon the protein tyrosine kinase activity of the insulin receptor.

Acanthosis Nigricans↗
PubMed1985

Dermatologic diseases of the nail unit other than psoriasis and lichen planus.

Diseases in which involvement of the nails may be helpful in the diagnosis of dermatologic disease elsewhere include psoriasis, lichen planus, Darier's disease, alopecia areata and totalis, keratotic scabies, scleroderma, and lupus erythematosus and dermatomyositis. Dermatologic diseases in which involvement of the nail commonly occurs but is relatively nonspecific and not diagnostic include dermatitis, lichen striatus, parakeratosis pustulosa, pityriasis rubra pilaris, acrokeratosis paraneoplastica, pemphigus vulgaris, epidermolysis bullosa, porokeratosis of Mibelli, and acanthosis nigricans. These entities are described and treatments summarized as appropriate.

Acanthosis Nigricans↗
PubMed1985

[Risk findings of the gastric mucosa--a clinicopathologic discussion].

Histological results of gastric biopsies necessitate a careful discussion between the gastroenterologist and pathologist in order evaluate the significance of the findings and to determine, what should be done next. Risk factors may be defined on the basis of clinical and endoscopic as well as of histological findings. Circumscript lesions of the gastric mucosa are such risk factors; histological examination of these lesions has to be done in quite a few cases repeatedly in order to confirm the diagnosis. Especially precancerous changes maybe considered as risk factors; according to WHO-definition they are subdivided in precancerous conditions and precancerous lesions. Precancerous conditions are type A gastritis, status after surgery of the stomach, hyperplasiogenic polyps of the stomach, increased familiar incidence of carcinoma, Ménétrier's disease, and acanthosis nigricans. Precancerous lesions on the other side are circumscript, histologically definable tissue changes, like for instance adenoma of the stomach, where formation of carcinoma can be observed with higher than normal incidence. Chronic atrophic gastritis has been overestimated considerably as a precancerous lesion. Control biopsies are indicated only in large time intervals and if special, well defined histological conditions prevail. Carcinoma incidence after Billroth II-resection of the stomach is lower in Middle Europe and U.S.A. than has been assumed before. Regular gastroscopic check-ups seem only to be justified in persons over 50 years of age, or in persons who have been operated upon more than 15 years ago. The procedures to be taken if gastric polyps are present depend upon localisation and size of the tumor and histology of the forceps biopsy. If adenoma are found or borderline lesions, which are to be considered as real precancerous lesions total excision by endoscopy, or if necessary by surgery is indicated.

Acanthosis Nigricans↗
PubMed1979

[Autoimmunological receptor diseases].

Specific chemical signals are recognized by cell receptors which initiate an appropriate biologic response. Autoimmune reactions against hormone receptors can lead to failure of receptor function. Several mechanisms are responsible for either abnormal stimulation or blockade of the receptor-mediated intracellular events. Immunoglobulins which compete with hormone binding to receptors have been found in Graves' disease, in myasthenia gravis, in acanthosis nigricans with insulin resistance, and in a seizure disorder with primary IgA deficiency.

Acanthosis Nigricans↗
PubMed1984

[Cutaneous paraneoplastic syndromes].

The authors list the really significant paraneoplastic cutaneous syndromes: acanthosis nigricans, paraneoplastic acrokeratosis, acquired ichthyosis (and eventually the "explosive" onset of seborrheic warts) and a special type of desquamative circinate erythema (erythema gyratum repens). The possible paraneoplastic character of other conditions is also discussed: dermatomyositis, necrosing vasculitis, autoimmune bullous conditions and pruritus "sine materia".

Acanthosis Nigricans↗
PubMed1978

Skin signs of internal malignancy.

Nonspecific dermatologic problems occasionally associated with malignant disease include pruritus, reactive erythemas and skin infections. Frequently associated with internal neoplasms are acanthosis nigricans, dermatomyositis, rapid development of multiple seborrheic keratoses, hypertrichosis lanuginosa and other syndromes. Skin metastases may be the first signs of internal cancer. The most common visceral primaries are the lung and colon in men and the breast, colon and ovary in women. Recognizing these lesions can lead to early diagnosis and improved prognosis.

Acanthosis Nigricans↗
PubMed1983

[Reticulated pigment anomaly of the skinfolds].

We report a case of reticulate pigmented anomaly of the flexures in a 54 years-old white male patient. His lesions had developed during the last 30 years, involving neck, axillae, groins, anterior chest wall, scrotum, buttocks and thighs. The abnormality is characterized by pigmented epidermal downgrowths, with similar lesions developing around dilated pilosebaceous follicles. The condition may be compared with acanthosis nigricans. For this reason it is important to recognize this new genodermatosis in order to avoid unnecessary investigations to exclude visceral malignancy.

Acanthosis Nigricans↗
PubMed1984

Defect in insulin receptor phosphorylation in erythrocytes and fibroblasts associated with severe insulin resistance.

The insulin receptor is a tyrosine-specific protein kinase. Upon binding of the hormone, the kinase is activated resulting in autophosphorylation of the receptor. This kinase activity has been postulated to be an early step in the transmembrane signaling produced by insulin. To evaluate the physiologic relevance of receptor phosphorylation, we have studied insulin binding and autophosphorylation properties using cells from an individual with a variant of the Type A syndrome of severe insulin resistance and acanthosis nigricans. Erythrocytes and cultured fibroblasts from this individual exhibited normal or near normal 125I-insulin binding. Receptors extracted from erythrocytes with Triton X-100 also exhibited normal 125I-insulin binding and competition curves. Despite this, receptors extracted from both erythrocytes and fibroblasts showed a 50% decrease in insulin-stimulated autophosphorylation. Partially purified receptors from the patient's fibroblasts also exhibited a 40% decrease in their ability to phosphorylate exogenous substrates. These data suggest that the insulin resistance in this syndrome is due to a genetic abnormality which impairs insulin receptor phosphorylation and kinase activity and further support the possible role of receptor phosphorylation and kinase activity in insulin action.

Acanthosis Nigricans↗