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March 20, 1967

Acanthosis Nigricans And Pituitary Tumors

JAMA. 1967;199(12):948. doi:10.1001/jama.1967.03120120136040

To the Editor:—  "Acanthosis Nigricans and Pituitary Tumors" (198: 619, 1966) by J. Brown, R. K. Winkelmann, and R. V. Randall discusses a multitude of conditions associated with acanthosis nigricans without classifying them beyond a division into malignant or benign types. However, classification into several types is necessary since great differences with regard to prognosis, inheritance, and reversibility exist between acnathosis nigricans in the various associations.I suggest the following classification:Type I: Malignant acanthosis nigricans, associated with an internal adenocarcinoma, occurring usually after puberty, usually fatal, and not proved to be genetically determined.Types II to IV: Not associated with an internal adenocarcinoma and therefore "benign" in a broad sense of the word.Type II: True benign acanthosis nigricans, present at birth or beginning in childhood or at puberty, resembling ichthyosis hystrix, inherited in an irregularly dominant manner, and not associated with endocrine disease.Type III: Pseudo- (secondary) acanthosis