What is the prognosis of acanthosis nigricans (AN)?

Updated: Oct 14, 2020
  • Author: Jason H Miller, MD; Chief Editor: William D James, MD  more...
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The prognosis for patients with malignant acanthosis nigricans is often poor. The associated malignancy frequently is advanced, and the average survival of these patients is approximately 2 years.

Patients with the benign form of acanthosis nigricans experience very few, if any, complications of their skin lesions. However, many of these patients have an underlying insulin-resistant state that is the cause of their acanthosis nigricans. The severity of the insulin resistance is highly variable and ranges from an incidental finding after routine blood studies to overt diabetes mellitus. The severity of skin findings may parallel the degree of insulin resistance, and a partial resolution may occur with treatment of the insulin-resistant state.

Insulin resistance is the most common association of acanthosis nigricans in the younger population. New studies indicate that children with acanthosis nigricans have higher levels of basal and glucose-stimulated insulin compared with obese children without acanthosis nigricans, suggesting an association of acanthosis nigricans with hyperinsulinemia independent of body mass index. [22, 23]

Malignant acanthosis nigricans is associated with significant complications because the underlying malignancy is often an aggressive tumor. Average survival time of patients with signs of malignant acanthosis nigricans is 2 years, although cases in which patients have survived for up to 12 years have been reported. In older patients with new-onset acanthosis nigricans, most have an associated internal malignancy.

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