Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- presença de fatores de risco
- ascendência negra ou hispânica
- novas lesões aveludadas pigmentadas nas axilas ou nas áreas flexoras
- lesões distribuídas na parte posterior do pescoço, axilas, vulva, umbigo, parte interna das coxas e virilha
- ganho de peso
- distribuição generalizada
- surgimento súbito de várias ceratoses seborreicas
Otros factores de diagnóstico
- idade >40 anos
- criança/adulto jovem
- sexo feminino
- acrocórdones
- distribuição acral
- prurido
- lesões nas mucosas e palmoplantares
- perda de peso
Factores de riesgo
- obesidade
- resistência insulínica
- história familiar positiva de acantose nigricans ou síndrome genética
- história familiar de diabetes mellitus
- neoplasia maligna
- medicamento
Pruebas diagnósticas
Pruebas diagnósticas que deben considerarse
- glicemia de jejum
- insulina no sangue em jejum
- tomografia computadorizada (TC) abdominal
- biópsia de pele
Algoritmo de tratamiento
apresentação inicial com causa subjacente
não resolvida apesar do tratamento da causa subjacente, hereditária ou idiopática
Colaboradores
Autores
David S. Cassarino, MD, PhD
Consultant Dermatopathologist
Southern California Permanente Medical Group
Sunset Medical Center
Los Angeles
CA
Divulgaciones
DSC declares that he has no competing interests.
Agradecimientos
Dr David Cassarino would like to gratefully acknowledge Dr Laura Westerling for her contribution to this topic. LNW declares that she has no competing interests.
Revisores por pares
Christine Ko, MD
Assistant Professor of Dermatology
Department of Dermatology
Yale University
New Haven
CT
Disclosures
CK declares that she has no competing interests.
John English, MBBS, FRCP
Consultant Dermatologist
Department of Dermatology
Queen's Medical Centre
Nottingham University Hospitals
Nottingham
UK
Disclosures
JE declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Das A, Datta D, Kassir M, et al. Acanthosis nigricans: a review. J Cosmet Dermatol. 2020 Aug;19(8):1857-65. Abstract
Schwartz RA. Acanthosis nigricans. J Am Acad Dermatol. 1994 Jul;31(1):1-19. Abstract
Patel NU, Roach C, Alinia H, et al. Current treatment options for acanthosis nigricans. Clin Cosmet Investig Dermatol. 2018 Aug 7:11:407-13.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Nevo epidérmico
- Doença de Dowling-Degos (anomalia pigmentada reticular das flexuras)
- Papilomatose confluente e reticulada (de Gougerot e Carteaud)
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