The Diabetes, Cancer, PCOS and Acanthosis Nigricans Link

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Copyright 2012 - Kris Heeter, Ph.D. (Reprinting, copying, or reproducing this article elsewhere online or offline is prohibited).


Acanthosis nigricans, pronounced (ak-an-THOE-sis NIE-grih-kuns), is a skin disorder that is associated with three major diseases:


Diabetes

Cancer

PCOS (polycystic ovary syndrome)


Those with the acanthosis nigricans disorder develop darker, thick, velvety skin in body folds and creases.

This disorder can be considered both a risk factor for some diseases (like diabetes) and a consequence of several diseases such as those mentioned above.


Causes of "acanthosis nigricans"

While it can be genetically inherited, there are also a number of non-genetic causes.


Some common causes include:

  • Obesity
  • Insulin resistance (including diabetes)
  • PCOS (polycystic ovary syndrome)
  • Donahue Syndrome
  • Rabson-Mendenhall Syndrome


In addition some drugs can cause this skin condition:

  • human growth hormone
  • oral contraceptives
  • niacin
  • insulin
  • protease inhibitors
  • glucocorticoids


And some cancers have been known to be associated with it:

  • Lymphoma
  • Gastrointestinal cancer
  • Urinary tract cancer
  • Lung cancer
  • Uterine cancer


Insulin resistance is considered to be the most common cause of acanthosis nigricans.

Insulin resistance means there is more circulating insulin in the body that eventually can lead to an insulin spillover into the skin, resulting in an abnormal increase in growth of the skin (aka "hyperplasia").

Acanthosis nigricans can begin at any age and it is more common in people who have dark skin.


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Acanthosis nigricans symptoms and diagnosis

Acanthosis nigricans usually appears slowly.

As it develops, the skin around the armpits, groin and neck eventually becomes dark and velvety, particularly in the skin folds or creases.

It can also develop over the joints of the fingers and toes and on the lips. In rare circumstances, the affected areas may itch.

Acanthosis nigricans can be diagnosed by a medical provider typically just by looking at the skin. In some of the more unusual cases, a skin biopsy is needed.



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The diabetes and acanthosis nigricans link

With diabetes, if insulin levels are too high in the body, the extra insulin can trigger the hyperplasa activity in skin cells which ultimately causes skin changes characteristic of acanthosis nigricans.

This can happen prior to the onset of diabetes, during what is considered a “prediabetes” phase as insulin levels in the blood are starting to rise. Or, it can occur after the onset of diabetes.

Often times an acanthosis nigricans, in non-diabetics, is considered a diabetes risk factor.

Acanthosis nigricans caused by hereditary factors, drugs or cancer can be an early warning that the individual is at a high risk for diabetes.


The cancer and acanthosis nigricans link

In reference to cancer, acanthosis nigricans is considered a “paraneoplastic syndrome”.

Paraneoplastic syndromes can be diseases or symptoms that are the consequence of cancer elsewhere in the body. Some cancers are associated with an insulin imbalance.

While the observed link between insulin resistance and some cancers has been established, it is still poorly understood and it is still in the early stages of scientific research.

Insulin is an important growth factor for tissues in the body. High levels of insulin may signal some cells to proliferate more. Some tissues are more susceptible to high insulin levels for reasons that are still poorly understood.


The PCOS and acanthosis nigricans link

Women with Polycystic Ovarian Syndrome (PCOS) frequently have insulin resistance.

PCOS is a hormonal imbalance that is linked to the way the body processes insulin after it has been produced by the pancreas.

Excess insulin circulating can stimulate the ovaries to produce large amounts of the male hormone testosterone. Excess testosterone can prevent the ovaries from releasing an egg each month.

High levels of insulin can also increase the conversion of male hormones to female hormones in women. This imbalance between male and female hormones leads to increased weight gain and can cause the formation of cystic follicles or cysts in the ovary.

As described earlier, consistently high levels of insulin in the blood can lead to hyperplasia in the skin cell as described with diabetes. The high levels of insulin associated with PCOS increases both the risk of diabetes and the occurrence of acanthosis nigricans. And for that reason, PCOS is considered a diabetes risk factor.


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Several diseases and conditions with a common link

The link or common denominator between diabetes, some cancers, PCOS and acanthosis nigricans is clear:

* insulin *

The body's inability to handle insulin and blood glucose levels properly can trigger any one of these conditions.

Furthermore, having one of these conditions can be a risk factor for the other conditions based on this come tie to insulin levels.


Are there treatments for acanthosis nigricans?

There is no specific treatment for acanthosis nigricans — but treating any of the underlying conditions, such as diabetes and obesity, may cause the changes in the skin to fade as circulating insulin levels return to normal ranges.

When acanthosis nigricans is related to obesity, losing weight can often reverse the condition.


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Comments 5 comments

greatparenting profile image

greatparenting 4 years ago from philadelphia, pa and corolla, nc

Important hub. Just one note. My daughter has PCOS and she does have insulin resistance but not all women with PCOS do. PCOS is a syndrome with a variety of about 5 symptoms. Women can have just two of the symptoms and still have the syndrome. Voted up and useful just the same as insulin resistance is so prevalent for so many reasons.


Kris Heeter profile image

Kris Heeter 4 years ago from Indiana Author

@grandparenting - that is a very good point. PCOS is rather complicated and not all doctors are as well versed in it given that often some of the symptoms can be mistakenly attributed to something else. I've known a few women who have it. We've had some support groups pop up around here which is really nice.


teaches12345 profile image

teaches12345 4 years ago

This is quite an edcuation and interesting. It is astounding at how medical research has discovered the link between being overweight and various forms of illness such as diabetes. It seems recent but I am sure that information regarding this fact may have been known for years. It is important for people to become educated on keeping a proper diet and exercise to avoid illness and disease. Great hub topic and voted up!


m0rd0r profile image

m0rd0r 4 years ago from Sofia, Bulgaria

Bravo Kris, excellent informative hub.

I've seen this skin condition in my aunt. She is obese and Diabetes II.

I must say it is not pleasant. Very often the skin ruptures exactly on the thick patch of skin and the tissues are very hard to close and regenerate.

The best effect from my decoctions had Marigold (Calendula) slowly boiled for 10 minutes in lard.

The resulting toppical is applied on the skin, until the wound heals completely. (the skin must be kept clean all the time, or it will infect and become even more swallen)


phdast7 profile image

phdast7 4 years ago from Atlanta, Georgia

Hi Kris - Very interesting and informative Hub. There is diabetes in my family and yet I had never heard of this skin condition.

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