{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:35:00Z","timestamp":1792643700462,"version":"4.5.0"},"reference-count":85,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T00:00:00Z","timestamp":1594857600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acanthosis nigricans (AN) is a cutaneous disorder characterized by symmetric velvety hyperpigmented plaques on intertriginous areas like axilla, neck, inframammary, and groin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To summarize the pathophysiology and classification of AN, provide an update of diagnostic testing strategies, and describe the current therapeutic options described so far in the literature for this disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive english language literature search across multiple databases (PubMed, EMBASE, MEDLINE, and Cochrane) for keywords (alone and in combination) was performed. MeSH as well as non\u2010MeSH terms such as \u201cacanthosis nigricans,\u201d \u201cclassification,\u201d \u201cpathophysiology,\u201d \u201cdiagnosis,\u201d \u201ctreatment,\u201d \u201ctopical drugs,\u201d \u201csystemic drugs,\u201d \u201cchemical peeling,\u201d and \u201clasers\u201d were taken into consideration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The pathophysiology of AN revolves around a multifactorial stimulation of proliferation of epidermal keratinocytes and dermal fibroblasts. Various types of AN include benign, obesity\u2010associated, syndromic, malignant, acral, unilateral, medication\u2010induced, and mixed\u2010type. Homeostasis model assessment\u2010insulin resistance (HOMA\u2010IR) is a good tool for assessment of insulin resistance. Management involves general measures (weight reduction and addressing the underlying cause, if any), topical drugs (retinoids, vitamin D analogs, and keratolytics), oral drugs (retinoids and insulin sensitizers), chemical peels (trichloroacetic acid), and lasers (Long pulsed alexandrite, fractional 1550\u2010nm erbium fiber, and CO<jats:sub>2<\/jats:sub>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Acanthosis nigricans is a treatable condition; however, complete cure and disappearance of lesions are difficult to achieve. Weight reduction is the most scientific and practical management strategy. Long\u2010term studies and further research is warranted in the pathophysiology and treatment of this common condition.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.13544","type":"journal-article","created":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T21:00:38Z","timestamp":1591736438000},"page":"1857-1865","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":99,"title":["Acanthosis nigricans: A review"],"prefix":"10.1111","volume":"19","author":[{"given":"Anupam","family":"Das","sequence":"first","affiliation":[{"name":"Department of Dermatology KPC Medical College and Hospital Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debatri","family":"Datta","sequence":"additional","affiliation":[{"name":"Oliva Skin and Hair Clinic Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Kassir","sequence":"additional","affiliation":[{"name":"Worldwide laser institute Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5933-2913","authenticated-orcid":false,"given":"Uwe","family":"Wollina","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology St\u00e4dtisches Klinikum Dresden Academic Teaching Hospital of the Technical University of Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8223-2769","authenticated-orcid":false,"given":"Hassan","family":"Galadari","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences United Arab Emirates University Al Ain UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torello","family":"Lotti","sequence":"additional","affiliation":[{"name":"University of Studies Guglielmo Marconi Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Jafferany","sequence":"additional","affiliation":[{"name":"College of Medicine Central Michigan University Saginaw MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Grabbe","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Medical Center of the Johannes Gutenberg University Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8646-1179","authenticated-orcid":false,"given":"Mohamad","family":"Goldust","sequence":"additional","affiliation":[{"name":"University of Rome G. Marconi Rome Italy"},{"name":"Department of Dermatology University Medical Center Mainz Mainz Germany"},{"name":"Department of Dermatology University Hospital Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229-5178.137765"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1909.92550170001001g"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1976.tb04895.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1984.tb05698.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(94)70128-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2002.05150.x"},{"issue":"5","key":"e_1_2_8_8_1","first-page":"4133","article-title":"Acanthosis nigricans: To be or not to be afraid (Review)","volume":"17","author":"Popa ML","year":"2019","journal-title":"Oncol Lett"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2017.09.008"},{"key":"e_1_2_8_10_1","first-page":"502","volume-title":"Andrew\u2019s Diseases of the Skin: Clinical Dermatology","author":"James WD","year":"2020"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.12.070"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12079-017-0427-1"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijd.IJD_545_17"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.20344\/amp.10738"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20175514"},{"issue":"1","key":"e_1_2_8_16_1","first-page":"A5316","article-title":"Specific skin signs as a cutaneous marker of diabetes mellitus and the prediabetic state \u2010 a systematic review","volume":"64","author":"Bustan RS","year":"2017","journal-title":"Dan Med J"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229-5178.144529"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229-5178.146201"},{"issue":"3","key":"e_1_2_8_19_1","doi-asserted-by":"crossref","first-page":"180","DOI":"10.20452\/pamw.642","article-title":"Acanthosis nigricans as a paraneoplastic syndrome","volume":"119","author":"Krawczyk M","year":"2009","journal-title":"Pol Arch Med Wewn"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.14107"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12881-019-0748-4"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.13748"},{"issue":"8","key":"e_1_2_8_23_1","doi-asserted-by":"crossref","first-page":"13030\/qt50s903q","DOI":"10.5070\/D3238036001","article-title":"Dermatologic manifestations of acromegaly: a case in point and a focused review","volume":"23","author":"Degirmentepe EN","year":"2017","journal-title":"Dermatol Online J"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229-5178.202275"},{"issue":"4","key":"e_1_2_8_25_1","first-page":"361","article-title":"[Insulin resistant diabetes, acanthosis nigricans and Bartter\u2019s syndrome, a fortuitous association?]","volume":"49","author":"Puel O","year":"1992","journal-title":"Arch Fr Pediatr"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1974.01630010054013"},{"issue":"3","key":"e_1_2_8_27_1","first-page":"111","article-title":"Evaluation of short stature, carbohydrate metabolism and other endocrinopathies in Bloom\u2019s syndrome","volume":"66","author":"Diaz A","year":"2006","journal-title":"Horm Res"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/840492"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/934865"},{"issue":"8","key":"e_1_2_8_30_1","first-page":"1487","article-title":"Acanthosis nigricans associated with longstanding dermatomyositis","volume":"23","author":"Tuna Castro MA","year":"1996","journal-title":"J Rheumatol"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.50.9.703"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.1986.tb00533.x"},{"key":"e_1_2_8_33_1","volume-title":"Clinical Dermatology","author":"Schwartz RA","year":"1989"},{"key":"e_1_2_8_34_1","first-page":"365","article-title":"Lipoatrophic diabetes mellitus: a rare special type!","volume":"56","author":"Fathy SA","year":"2018","journal-title":"Endocr Abstr"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1964.03070070056020"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/096120339700600311"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2003.261"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1955.03730310065013"},{"issue":"5","key":"e_1_2_8_39_1","first-page":"12","article-title":"Insulin\u2010mediated pseudoacromegaly: a case report and review of the literature","volume":"104","author":"Yaqub A","year":"2008","journal-title":"W V Med J"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320370203"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1975.tb00124.x"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.160540"},{"key":"e_1_2_8_43_1","unstructured":"HAIR\u2010AN syndrome: a multisystem challenge \u2010 American Family Physician.https:\/\/www.aafp.org\/afp\/2001\/0615\/p2385.html. Accessed April 2 2020."},{"issue":"11","key":"e_1_2_8_44_1","first-page":"785","article-title":"[Werner\u2019s syndrome with early onset with hyperandrogenism caused by ovarian hyperthecosis, acanthosis nigricans and peripheral neuropathy]","volume":"117","author":"Blanc F","year":"1990","journal-title":"Ann Dermatol Venereol"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.1997.tb02810.x"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229-5178.146184"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijpd.IJPD_34_18"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S137527"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.91828"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.5070\/D37MF6G290"},{"issue":"3","key":"e_1_2_8_51_1","first-page":"159","article-title":"Topical tretinoin in acanthosis nigricans","volume":"62","author":"Lahiri K","year":"1996","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1991.01680070039003"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1973.01620220087029"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/dth.12224"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.147838"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.13799"},{"issue":"1","key":"e_1_2_8_57_1","first-page":"33","article-title":"Topical therapy with tretinoin and ammonium lactate for acanthosis nigricans associated with obesity","volume":"71","author":"Blobstein SH","year":"2003","journal-title":"Cutis"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001050000083"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1K446"},{"issue":"3","key":"e_1_2_8_60_1","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.jaad.2004.09.028","article-title":"Hyperkeratosis of the nipple associated with acanthosis nigricans: treatment with topical calcipotriol","volume":"52","author":"Lee HW","year":"2005","journal-title":"J Am Acad Dermatol"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546630802050506"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546634.2019.1708855"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.3109\/09546634.2012.674194"},{"issue":"2","key":"e_1_2_8_64_1","first-page":"170","article-title":"To compare the efficacy and safety of trichloroacetic acid peel with topical tretinoin in the treatment of acanthosis nigricans: A randomized controlled study","volume":"29","author":"Rajegowda HM","year":"2019","journal-title":"J Pakistan Assoc Dermatologists"},{"issue":"6","key":"e_1_2_8_65_1","first-page":"299","article-title":"Generalized acanthosis nigricans related to type B insulin resistance syndrome: a case report","volume":"86","author":"Jeong KH","year":"2010","journal-title":"Cutis"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1980.01640250112027"},{"issue":"6","key":"e_1_2_8_67_1","first-page":"677","article-title":"Improvement of acanthosis nigricans on isotretinoin and metformin","volume":"2","author":"Walling HW","year":"2003","journal-title":"J Drugs Dermatol"},{"issue":"9","key":"e_1_2_8_68_1","first-page":"1151","article-title":"Palliative treatment of paraneoplastic acanthosis nigricans and oral florid papillomatosis with retinoids","volume":"9","author":"Swineford SL","year":"2010","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546630500497280"},{"issue":"2","key":"e_1_2_8_70_1","doi-asserted-by":"crossref","first-page":"173","DOI":"10.2340\/0001555566173174","article-title":"Treatment of acanthosis nigricans with etretinate (Tigason) in a patient with Lawrence\u2010Seip syndrome (generalized lipodystrophy)","volume":"66","author":"M\u00f8rk NJ","year":"1986","journal-title":"Acta Derm Venereol"},{"key":"e_1_2_8_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(09)80242-9"},{"issue":"8","key":"e_1_2_8_72_1","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1111\/j.1742-1241.2002.tb11327.x","article-title":"Therapeutic approach in insulin resistance with acanthosis nigricans","volume":"56","author":"Tankova T","year":"2002","journal-title":"Int J Clin Pract"},{"key":"e_1_2_8_73_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPEM.2008.21.4.339"},{"key":"e_1_2_8_74_1","doi-asserted-by":"publisher","DOI":"10.1159\/000185493"},{"key":"e_1_2_8_75_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03345776"},{"key":"e_1_2_8_76_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.13206"},{"key":"e_1_2_8_77_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijd.IJD_417_17"},{"issue":"9","key":"e_1_2_8_78_1","first-page":"884","article-title":"Comparison of metformin versus rosiglitazone in patients with Acanthosis nigricans: a pilot study","volume":"5","author":"Bellot\u2010Rojas P","year":"2006","journal-title":"J Drugs Dermatol"},{"issue":"2","key":"e_1_2_8_79_1","first-page":"160","article-title":"Regression of Acanthosis Nigricans with the addition of sitagliptin and pioglitazone","volume":"64","author":"Adderley\u2010Rolle EM","year":"2015","journal-title":"West Indian Med J"},{"issue":"8","key":"e_1_2_8_80_1","first-page":"1158","article-title":"Treatment of Acanthosis nigricans of the axillae using a long\u2010pulsed (5\u2010msec) alexandrite laser","volume":"30","author":"Rosenbach A","year":"2004","journal-title":"Dermatol Surg"},{"issue":"4","key":"e_1_2_8_81_1","first-page":"290","article-title":"Comparison of long\u2010pulsed alexandrite laser and topical tretinoin\u2010ammonium lactate in axillary acanthosis nigricans: A case series of patients in a before\u2010after trial","volume":"7","author":"Ehsani A","year":"2016","journal-title":"Caspian J Intern Med"},{"key":"e_1_2_8_82_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-019-02944-9"},{"issue":"2","key":"e_1_2_8_83_1","first-page":"AB172","article-title":"Acanthosis nigricans of the lips treated with carbon dioxide laser ablation","volume":"64","author":"Amanda Jacobs M","year":"2011","journal-title":"J Am Acad Dermatol"},{"key":"e_1_2_8_84_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-018-2505-x"},{"key":"e_1_2_8_85_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03349042"},{"issue":"12","key":"e_1_2_8_86_1","first-page":"1059","article-title":"[Systemic photochemotherapy (PUVA) in acanthosis nigricans maligna: regression of keratosis, hyperpigmentation and pruritus]","volume":"64","author":"Bonnekoh B","year":"1989","journal-title":"Z Hautkr"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjocd.13544","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.13544","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocd.13544","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.13544","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T08:34:23Z","timestamp":1723019663000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.13544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,16]]},"references-count":85,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1111\/jocd.13544"],"URL":"https:\/\/doi.org\/10.1111\/jocd.13544","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,16]]},"assertion":[{"value":"2020-02-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}