The Diabetes, Cancer, PCOS and Acanthosis Nigricans Link
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:
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:
- 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
- protease inhibitors
And some cancers have been known to be associated with it:
- 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.
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.
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.