ACANTHOSIS NIGRICANS IN OBESE VERSUS NON-OBESE IN A TERTIARY CARE HOSPITAL ASSOCIATION WITH BMI AND CENTRAL OBESITY
Authors:   Associate Professor and Head of Dermatology Department at Karachi Institute of Medical Sciences (KIMS), MalirCantt Karachi., Niaz Furquana , Shams Nadia ,   Professor & HOD Medicine at Rawal Institute of Health Sciences, Islamabad., Sheikh Irfan ,   Professor & HOD Dermatology at Chandka Medical College/Shaheed Mohtarma Benazir Medical University, Larkana., Kumar Naresh ,   Assistant Professor at Medicine Dept, Dow Medical University/Civil Hospital Karachi., ahmed Najia ,   Associate Professor at Dermatology DeptBahriaMedical University /Consultant Skin Specialist at PNS shifakarachi., Kamran Mahrukh ,   Assistant Professor at Anatomy Dept DIMC, Ojha Campus /DUHS karachi., Islam Nayyerul ,   Professor, Associate Dean of Faculty & HOD Medicine, Karachi Institute of Medical Sciences, Karachi., Ahmed Waqar ,   Consultant Pediatrician at WWL NHS Trust, UK.
Published: August 2021

Background and objectives:Acanthosis nigricans (AN) is a major cosmetic and pathological condition associated with obesity,hirsutism, polycystic ovary, DM, metabolic syndrome and insulin resistance. This study was conducted to determine frequency of obesity in acanthosis nigricans and the association of BMI and central obesity with gender, age andtype of AN. Methodology: This hospital based observational study was conducted from1st March to 31st May 2021 at department of Medicine RIHS Islamabad after ethical approval. Sample size was calculated to be 221.Inclusion criteria: Adult cases of both the genders presenting with AN in medical OPD. Exclusion criteria:Diagnosed cases of malignancy, critically ill cases, endocrine disorders and pregnant women were excluded.After detailed history and examination, clinical diagnosis of Acanthosis nigricanswasmade. The weight in kg and height in meters measured and BMI calculatedby formula weigh in Kg/height (m2).Waist circumference measured in cm by flexible measuring tape from narrowest part of torso,midway between the lowest rib and iliac crest for central obesity and relevant investigations suggested. Data analyzed by SPSS version 21.Chi-square test was used to compare various variables between obese and non-obese AN cases with significant p<0.05. Results: Among 221 cases with acanthosis nigricans, there were152(68.8%)females and 69(31.2%) males . The mean age was 27 + 13.56 years with a range of 18-64 years. The mean BMI was 31.63 + 6.92 kg/m2.Obesity was observed in 144(65%).Mean waist circumference was 37.75 + 13.73 inches. Most frequent site involved was neck (98.6%), followed by groin (80.5%), knuckles (59.7%),sub-mammary (49%) and axilla (47%).The benign acanthosis nigricans was most frequent(98.6%) followed by HAIR AN Syndrome 46% cases, acral AN14%, Syndromic AN 1.7% and mixed 1.4%. No case had unilateral AN.The types of AN had no association with obesity (p>0.05).Diabetes mellitus observed in 47 (21%) AN cases.Polycystic ovaries (PCOs) in 111 out of 152 females with AN. Autoimmune conditions seen in 53(24%) AN cases. Conclusion: Benign and HAIR-AN were most frequent type in our study that was associated with raised BMI, waist circumference, PCOS and diabetes. It is recommended to screen acanthosis nigricans cases regardless of age or gender for obesity, PCOS, DM, hypertension and autoimmune conditions. Hence,early diagnosis may improve quality of life, prevent complications of systemic disease and improve outcome of diseases and quality of life of patients.