Acanthosis nigricans is a common skin presentation of insulin resistance. We may observe different forms of its sevirity. Pathogenesis of this disorder is correlated with an action of insulin to keratinocyte and dermal fibroblasts via interaction with IGFR1.
We'd like to present a medical history of two patients admitted to our clinic because of severe acanthosis nigricans. Boys were at the age of 13 and 14 years. We diagnosed carbohydrate metabolism disorders with severely increased levels of fasting insulin and excessive secretion of insulin in oral glucose tolerance tests. We excluded all potential reasons: malignancy and endocrine disorders responsible for acanthosis nigricans. We are still waiting for the results of genetic tests. After dietetary intervention resulting in succesful lost of weight we observed substantial decrease in insulin levels and crucial reduction of acanthosis nigricans.
Loss of weight is the most important factor leading to improvement of metabolic disorders presented in obese patients. Features of insulin resistance deplete more effectivelly in biochemical tests than in a fenotype of those patients.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology