A. Cushing’s Disease
B. Polycystic Ovary Disease
D. All of the above
Ans:D. All of the above.
The patient in question is suffering from Acanthosis Nigricans.
- Acanthosis nigricans is a brown to black, poorly defined, velvety hyperpigmentation of the skin. It is usually found in body folds, such as the posterior and lateral folds of the neck, the armpits, groin, navel, forehead, and other areas.
- It typically occurs in individuals younger than age 40, may be genetically inherited, and is associated with obesity or endocrinopathies, such as hypothyroidism, acromegaly, polycystic ovary disease, insulin-resistant diabetes, or Cushing’s disease
Type I – familial
- Familial acanthosis may arise as a result of an autosomal dominant trait, presenting at birth or developing during childhood.
Type II – endocrine
- Endocrine syndromes associated with acanthosis nigricans can develop in many conditions, particularly:
- starts with insulin resistance, such as diabetes mellitus and metabolic syndrome
excess circulating androgens, particularly Cushing’s disease, acromegaly, polycystic ovarian disease
- Addison’s disease and hypothyroidism
- Rare diseases, including pinealoma, leprechaunism, lipoatrophic diabetes, pineal hyperplasia syndrome, pituitary basophilism, ovarian hyperthecosis, stromal luteoma, ovarian dermoid cysts, Prader-Willi syndrome, and Alstrom syndrome.
Type III – obesity and pseudoacanthosis nigricans
Type IV – drug-related
- Acanthosis nigricans has been linked to the use of nicotinic acid, glucocorticoid use, combined oral contraceptive pills, and growth hormone therapy.
Type V – malignancy
- Malignant acanthosis nigricans refers to acanthosis nigricans occurring as a paraneoplastic syndrome associated with a cancer. Malignant acanthosis nigricans is most commonly associated with gastrointestinal adenocarcinomas, as well as genitourinary cancers such as those of the prostate, breast, and ovary. Other cancers, such as those of the lung, stomach, and lymphoma, are occasionally associated with acanthosis nigricans.