Acanthosis Nigricans Medication

  • Author: Jason H Miller, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jul 15, 2010
 

Medication Summary

The goal of pharmacotherapy in acanthosis nigricans is to improve cosmetic appearance.

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Topical retinoids

Class Summary

These agents promote shedding of hyperkeratotic skin. They are modifiers of keratinocyte adhesion, differentiation, and proliferation.

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Tretinoin topical (Avita, Retin-A)

 

Promotes detachment of cornified cells and enhances shedding of corneocytes. Inhibits microcomedo formation and eliminates lesions that are present. Makes keratinocytes in sebaceous follicles less adherent and easier to remove.

Available as 0.025%, 0.05%, and 0.1% creams. Available also as 0.01% and 0.025% gels.

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Keratolytic Agent

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Ammonium lactate

 

Alpha-hydroxy acid; normal constituent of tissues and blood. Believed to act as humectant when applied to the skin. This may influence hydration of the stratum corneum. In addition, when applied to the skin, may act to decrease corneocyte cohesion. The mechanism(s) by which this is accomplished is not yet known.

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Contributor Information and Disclosures
Author

Jason H Miller, MD  Private Practice, Hametz and Picascia Dermatology Associates, Freehold, New Jersey

Jason H Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, and Society for Pediatric Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Ronald P Rapini, MD  Josey Professor and Chair, Department of Dermatology, Professor of Pathology, University of Texas Medical School at Houston and MD Anderson Cancer Center

Ronald P Rapini, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Society for Investigative Dermatology, and Texas Medical Association

Disclosure: Elsevier publishers Royalty Independent contractor

Specialty Editor Board

Ponciano D Cruz Jr, MD  Vice-Chair, JB Shelmire Professor, Department of Dermatology, University of Texas Southwestern Medical Center

Ponciano D Cruz Jr, MD is a member of the following medical societies: Texas Medical Association

Disclosure: RCTS Consulting fee Independent contractor; Mary Kay Cosmetics Honoraria Consulting; Galderma Grant/research funds Principal Investigator

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Edward F Chan, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Jonathan Baron, MD, and Norman Levine, MD, to the development and writing of this article.

References

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  26. Rosenbach A, Ram R. Treatment of Acanthosis nigricans of the axillae using a long-pulsed (5-msec) alexandrite laser. Dermatol Surg. Aug 2004;30(8):1158-60. [Medline].

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Brown velvety plaques with skin tags in the axilla of a patient with acanthosis nigricans.
Acanthosis nigricans.
Acanthosis nigricans, obesity related.
Acanthosis nigricans of the axilla with one skin tag.
Acanthosis nigricans biopsy. The epidermis is papillomatous (undulates) and pigmented ("nigricans"). Acanthosis (thickening of the spinous layer) is often not really present, so acanthosis nigricans is often a misnomer in many cases.
Table. Acanthosis Nigricans Associations
Syndromes Associated With Acanthosis NigricansMalignant Diseases Associated With Acanthosis Nigricans
AcromegalyBile duct cancer
Alstrom telangiectasiaBladder cancer
Barter syndromeBreast cancer
Beare-Stevenson syndromeColon cancer
Benign encephalopathyEndometrial cancer
Bloom syndromeEsophageal cancer
Capozucca syndromeGallbladder cancer
Chondrodystrophy with dwarfismHodgkin disease
Costello syndromeKidney cancer
Crouzon syndromeLiver cancer
DermatomyositisLung cancer
Familial pineal body hypertrophyMycosis fungoides
GigantismNon-Hodgkin lymphoma
Hashimoto thyroiditisOvarian cancer
Hirschowitz syndromePancreatic cancer
Lawrence-Moon-Bardet syndromePheochromocytoma
Lawrence-Seip syndromeProstate cancer
Lipoatrophic diabetes mellitusRectal cancer
Lupoid hepatitisTesticular cancer
Lupus erythematosusThyroid cancer
PhenylketonuriaWilms tumor
Pituitary hypogonadism
Pseudoacromegaly
Prader-Willi syndrome
Pyramidal tract degeneration
Rud syndrome
Scleroderma
Stein-Leventhal syndrome
Type A syndrome (HAIR-AN syndrome)
Werner syndrome
Wilson syndrome
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