My neck has darkened, now what?
Just as the eyes are the windows to the soul, the skin can reflect our health. Acanthosis nigricans is a skin condition characterized by increased pigmentation and thickness, appearing as a brownish, velvety plaque with accentuated skin folds. It can occur at any age and in any gender. Alongside it, we often observe pedunculated, polyp-like growths called skin tags. It is generally seen in areas of skin folds and friction, such as the neck, armpits, and groin. It can also appear on knuckles, elbows, knees, the under-breast area, the inner thighs, and the antecubital and popliteal fossae. It initially appears on the nape of the neck and then progresses to other parts of the body.
It is associated with insulin resistance and serves as an indicator of it. This resistance leads to an excess of insulin, which stimulates the proliferation of skin cells, resulting in acanthosis nigricans. We could say that it constitutes a cutaneous manifestation of hyperinsulinism.
It can be observed in pathologies associated with insulin resistance such as obesity (although it is also observed in patients with normal weight), diabetes, alterations in sugar tolerance, polycystic ovary syndrome, drug reactions and concomitant with malignant diseases, where its cutaneous expression becomes severe, as well as genetic causes.
The doctor should evaluate the presence of signs of hyperandrogenism in women of reproductive age (hair loss, increased body hair, acne, sweating, oily skin, menstrual cycle irregularities, history of infertility, miscarriages) that would raise suspicion of Polycystic Ovary Syndrome.
Acanthosis nigricans requires thorough evaluation to ensure appropriate management. Treatment is primarily aimed at addressing the underlying cause. The use of skin-lightening creams or other cosmetic or interventional treatments should be prescribed by a dermatologist.
If you have any questions, leave them in the comments…
Dr. Lucía Gonçalves Jardim