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Diabetes Q&A | Type 2 | I have acanthosis nigrican, and have th
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09/04/09 05:05 PM

"I have acanthosis nigrican, and have the same dark patch on the sides of my feet and on top. Could this be the same thing as AN, or RA that I have?"
Asked By: motherangel  
Category: Type 2

Background Info Hide
I have acanthosis nigrian on: back of neck, underarms, inner thighs, back of leg from knee up, elbows and hand knucles. For the past three years, I have the same dark patchs on the side of my feet, and on top. I also have RA, and was wondering if the dark patches on my feet is AN also. It leaves my feet skin tight and hard to flex. I have Type 2 diabetes. My knuckles are swollen, sharp pain, dark, curving toward the pinky finger, and now it hurts to open lids. I also have diabetic neuropathy and ankylosis spondilitis

Expert Answers (1)

10/10/09 02:32 PM

Hello MotherAngel: Acanthosis nigricans (AN) is typically described as velvety, light brown to black hyper pigmented plaques that appear in the folds of the skin. Usually the thickened skin is seen in the neck and armpit areas, other areas include the grain, umbilicus, under area of the breast and hands. 8 different forms of AN have been identified, the one most common seen with diabetes is associated with insulin resistance and obesity. The dark color is due to the thickness of your keratin-containing layers of skin. Sudden appearance should be investigated with your medical practioner, and AN lesions warrant a through work up as to rule out potential 'critical' causes.

Treatment for AN related to diabetes, include weight loss and improvement in glucose control or back to the basics:

  • ABCs of diabetes: A1C<7%
  • Blood pressure<130/80mmHg
  • Tchol<200,HDL>50,LDL<100,TGs<150mg/dl.

    If it is diabetic thick skin, resulting in stiff joints and limited mobility or skin thickness, unfortunately the causes are not fully known. Some speculation has been of an accumulation of collagen due to elevated glucose levels. This overproduction of collagen can manifest as tiny pebble-like spots that appear on the hand, knuckles and along the fingernails. Resulting in the difficulty of extending the fingers and result in contractures of the palm area, or referenced as Dupuytren's contracture.

    Consulting with your PCP may provide further understanding. Treatments focus on total glucose control, there may be some topical agents available for relief.

    Regarding the additional diagnosis of AS, currently no cure is known, although treatments and medications are available to reduce symptoms and pain. Physical therapy and exercise, along with medication, are at the heart of therapy for ankylosing spondylitis. Physiotherapy and physical exercises are preceded by medical treatment in order to reduce the inflammation and pain, and are commonly followed by a physician. If you are using any NSAIDS for pain relief, caution is advised with diabetes. Be your best and thank you for asking dLife. Call on us as needed. Regards Sue

    • Answered By: Susan Throop
    Accreditations: RD, CDE, MA
    Sources Show

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