The term acanthosis nigricans1 refers to the histopathologic changes in the skin which serve to identify this disorder—papillomatosis (wart-like or ridge-like hypertrophy) and (melanin) hyperpigmentation. The two types which have been distinguished are of equal incidence but are at opposite poles prognostically. The "benign" form is the cutaneous expression of a harmless hereditary disease, whereas the "malignant" form is invariably identified with carcinoma.
The skin lesions in either type of "true" acanthosis nigricans are usually symmetrically distributed. The areas of predilection include the body folds, particularly the axillas, the intermammary and inframammary areas, the umbilicus, the groin, the inner aspects of the thighs, the genitalia, the intergluteal, perianal, and perineal areas, and the antecubital and popliteal areas. The lesions have been observed also on the lids, lips, the neck, the forearms and hands, the hypogastrium, the intervertebral furrow, the mucous membranes of the cheek, the tongue, the epiglottis, the
ACANTHOSIS NIGRICANS. JAMA. 1960;174(9):1196. doi:10.1001/jama.1960.03030090052013
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