ACANTHOSIS NIGRICANS

From Big Medical Encyclopedia

ACANTHOSIS NIGRICANS [Greek akantha — a thorn and lat. nigricans — blackening; synonym: dystrophia papillaris et pigmentosa (Darier), keratosis nigricans (Kaposi), melanodermia papillaris (Gaucher)] — pigmental and papillary dystrophy of skin. Seldom found disease of skin of not clear etiology. And. the item is for the first time described in 1890 by Pollittserom and Yanovsky (S. Pollitzer, W. Janowsky).

Fig. 1. Acanthosis nigricans
Fig. 2. Acanthosis nigricans

Clinical forms

are Distinguished malignant (acanthosis nigricans maligna) and high-quality (acanthosis nigricans benigna — juvenilis) forms of a disease.

Acanthosis nigricans maligna treats a paraoncological dermatosis (see) also occurs at people 25 years are more senior, being often combined with cancer of internals: according to Mukai (F. Mukai, 1927) — at 45% of patients, by data to Darya (J. Darier, 1947) et al. — at 80% of patients, by data Ollendorff-Curt (H. Ollendorff-Curth, 1948) — at 50% of patients. Can precede development of cancer of internals. Acanthosis nigricans benigna (juvenilis) develops at the young people suffering from endocrine disturbances (diabetes, infantilism, an amenorrhea), diseases of a nervous system (epilepsy, an idiocy) with inborn malformations, etc. E.g., at Misher's syndrome the combination is observed And. item, diabetes mellitus, weak-mindedness, hypertrichosis and anomaly of teeth. Many authors carry acanthosis nigricans benigna (juvenilis) to genodermatoses (see) since this disease is revealed in several generations of one family.

Patogistologiya

the Hyperkeratosis, an acanthosis, increase in a pigment of melanin in cells of a basal layer of epidermis and existence in a derma of a large number of chromatophores, a papillomatosis; in an awl-shaped layer — mitoses. The inflammatory phenomena are insignificant, in top coats of a derma the perivascular infiltrate consisting of lymphocytes and considerable number of mast cells.

A clinical picture

Acanthosis nigricans benigna and maligna are shown by symmetrically located fleecy and warty keratosic growths of flaky-black color in the field of axillary hollows, a neck (fig. 1 and 2), external genitals, a crotch, an anus, inguinofemoral folds. The hyper pigmented skin is not shelled, the drawing it is sharply underlined. Vegetations in nostrils, around a mouth, in acoustical pass, on a mucous membrane of an oral cavity, a pharynx, a throat, a vagina, a gullet, a large intestine and in a renal pelvis are described. As a rule, And. the item does not cause subjective feelings, however sometimes patients complain of an itch, burning, feeling of tightness of skin.

The diagnosis

the Diagnosis is established on the basis of a clinical picture and histologic data. A certain difficulty is presented by differentiation And. the item and pseudoacanthosis nigricans having similarity on a clinical picture. Pseudoacanthosis nigricans is observed at the people having obesity is more often at women. The centers of defeat arise on places of friction of skin at the increased perspiration. Mucous membranes are not surprised. After weight loss there occurs improvement. Patogistologiya — the hyperplasia of a papillary layer of a derma and a hyperpegmentation are less expressed, than at And. item Besides, And. the item should be differentiated with an addisonovy disease at which there is no papillomatosis, and also with an ichthyosis, a disease to Darya, an argiriy, toxic melanoderma.

The forecast

the Forecast serious in view of a frequent combination And. the item with oncological diseases of internals.

Treatment

Fortifying means, polyvitamins, at indications — endocrine drugs. Careful hygienic care of skin, the general heat baths is necessary; locally — the softening ointments. Patients And. items shall be under dispensary observation of the oncologist and dermatologist.


Bibliography: Lonshakov Yu. I., Awards O. M. and Belyaev N. V. Acanthosis nigricans malignum. Messages, dermas, and veins., No. 9, page 72, 1969, bibliogr.; Rakhmanov V. A. Papillary and pigmental dystrophy of skin, Mnogotomn. the management on dermas. - veins., under the editorship of S. T. Pavlov, t. 3, page 382, M., 1964, bibliogr.; Belisario J. G. Hauterscaeimmgen bei malignen Erkrankungen, Hautarzt, Bd 22, S. 95, 1971; Curth H. O. Malignant acanthosis nigricans, Arch. Derm., v. 102, p. 479, 1970, bibliogr.; Darier J., Civatte A. et Tzanck A. Précis de dermatologie, p. 345, P., 1947; Duperrat B. Précis de dermatologie, p. 297, P., 1959; Engel S. Acanthosis nigricans benigna und Akromegalie, Derm. Mschr., Bd 156, S. 894, 1970, Bibliogr.; Gougerot H. et Carteaud A. Acanthosis nigricans, in book: Nouv. prat, derm., publ. par J. Darier e. a., t. 6, p. 416, P., 1936, bibliogr.

M. A. Rozentul.

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