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Dixit S, Chandra A, Kariwala P, Sachan B, Singh BP, Pathak A, Singh AK, Kandpal SD. Utility of "Acanthosis Nigricans" and "Skin Tags" as a screening tool for risk of developing noncommunicable diseases: A cross-sectional study at a health facility in Lucknow (India). Ann Afr Med 2024; 23:29-35. [PMID: 38358168 PMCID: PMC10922173 DOI: 10.4103/aam.aam_90_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/03/2023] [Indexed: 02/16/2024] Open
Abstract
Context Over the past three decades, there has been a significant rise in the prevalence of noncommunicable diseases (NCDs) globally, accompanied by a relative decline in communicable diseases. Aims With this background, the research was planned to determine the prevalence of acanthosis nigricans (AN) or skin tags (STs) in the study population and to examine the relationship between the presence of AN and ST with commonly used indicators such as waist-to-height ratio (W/Ht.), Indian Diabetes Risk Score (IDRS), and body mass index for predicting the risk of NCDs. Settings and Design This cross-sectional study was done at a health facility in Lucknow (India). Methodology Consecutive sampling was employed to select 152 apparently healthy adults as the participants. Data collection involved administering a questionnaire and conducting anthropometry using standardized methods. Visual inspection was conducted to identify AN or ST on the common sites. Statistical Analysis Used Data entry was done in Microsoft Office Excel, followed by data analysis using SPSS. To test the association between variables "significance of difference of mean," Chi-square test, logistic regression analysis, and estimation of Kohen's kappa were used. A "P" value was considered statistically significant at <0.05 level. The sensitivity and specificity of AN and ST were also estimated in predicting the risk of NCDs. Results The prevalence of AN was 19.08% (95% confidence interval [CI] = 12.76%-25.40%), while the prevalence of STs was 28.29% (95% CI = 21.05%-35.53%). AN showed a sensitivity of 22.4% and specificity of 96.3% with W/Ht. ratio as the standard, and a sensitivity of 26.44% and specificity of 90.77% with IDRS as the standard. ST exhibited a sensitivity of 32.0% and specificity of 88.89% with W/Ht. ratio as the standard, and a sensitivity of 37.93% and specificity of 84.62% with IDRS as the standard. Conclusion AN and ST can be used as simple and time-saving tools in screening protocols for (NCDs). Further research is desirable to validate the findings.
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Affiliation(s)
- Sumeet Dixit
- Department of Community Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Aditya Chandra
- Department of Community Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Peeyush Kariwala
- Department of Community Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Beena Sachan
- Department of Community Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Bhanu Pratap Singh
- Integral Institute of Medical Sciences and Research, Lucknow, Uttar Pradesh, India
| | - Anurag Pathak
- Department of Community Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Arvind K. Singh
- Department of Community Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - S. D. Kandpal
- Department of Community Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Artar G, Tas B, Turan G, Uckan HH. Evaluation of androgen-dependent skin findings of polycystic ovary syndrome (PCOS). Gynecol Endocrinol 2022; 38:1104-1108. [PMID: 36579834 DOI: 10.1080/09513590.2022.2162496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
AIM The purpose of the study was to investigate the biochemical and metabolic abnormalities related to the cutaneous characteristics of PCOS. MATERIAL–METHODS Patients diagnosed with PCOS were included in the study. Demographic data and accompanying androgen-dependent skin findings (acne, seborrhea, androgenic alopecia, acanthosis nigricans, skin tag, and hirsutism) were recorded. The free testosterone, total testosterone, dehydroepiandrosterone sulfate, androstenedione,17-Hidroksi progesterone, sex hormone binding globulin, prolactin, fasting glucose, fasting insulin, HbA1C, HDL, and triglycerides, follicle-stimulating hormone, luteinized hormone, free androgen index, and HOMA-IR levels of the patients were measured. The hormonal values of the patients with PCOS with and without skin findings were compared. RESULTS The HOMA-IR values of the acanthosis nigricans (+) PCOS group were significantly higher than the acanthosis nigricans (-) PCOS group (p < .001). The DHEA-SO4, FAI, and FI values of patients with hirsutism (HR) (+) PCOS were found to be statistically higher than patients with HR (-) PCOS (p = .006, p = .015, p = .004). CONCLUSION PCOS is among the most common endocrine disorders of women of reproductive age and was associated with some hormonal, metabolic, and skin findings. Certain androgenic and metabolic variables developing in PCOS might correlate with cutaneous symptoms.
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Affiliation(s)
- Gokhan Artar
- School of Medicine, Department of Obstetrics and Gynecology, Ege University, İzmir, Turkey
| | - Betul Tas
- Department of Dermatology, Health Sciences University Bağcılar Training and Research Hospital, Istanbul, Turkey
| | - Gokce Turan
- Department of Obstetrics and Gynecology, School of Medicine, Gazi University, Ankara, Turkey
| | - Hasan Huseyin Uckan
- Department of Obstetrics and Gynecology, School of Medicine, Gazi University, Ankara, Turkey
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Xiao TL, Duan GY, Stein SL. Retrospective review of confluent and reticulated papillomatosis in pediatric patients. Pediatr Dermatol 2021; 38:1202-1209. [PMID: 34561886 DOI: 10.1111/pde.14806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND/OBJECTIVES Confluent and reticulated papillomatosis is a skin condition with unclear etiology and limited understanding of risk factors, comorbidities, and treatment strategies in the pediatric population. This study aims to describe the varied presentations and outcomes of confluent and reticulated papillomatosis and report associated comorbidities in pediatric patients. METHODS In this retrospective single-institution case-control study, pediatric patients with a diagnosis of confluent and reticulated papillomatosis seen between 2012 and 2020 were matched approximately 1:5 with an acne vulgaris cohort based on diagnosis, setting, and time period when seen. The primary measures were the clinical features, demographics, comorbidities, treatment, and outcomes of patients with confluent and reticulated papillomatosis. Univariate and multivariable analyses were conducted to describe the association of confluent and reticulated papillomatosis with several potential risk factors and comorbidities. RESULTS Patients with confluent and reticulated papillomatosis typically presented in adolescence with a median age of 14 years and female predominance. In a multivariable analysis, patients with confluent and reticulated papillomatosis were significantly more likely to identify as Black, be overweight or obese, and have concurrent acanthosis nigricans compared to control patients. Most of the confluent and reticulated papillomatosis patients were treated with oral minocycline or doxycycline. Although all patients who received antibiotics responded to treatment, approximately half presented with recurrence, typically within 1-2 years of first treatment. CONCLUSIONS Confluent and reticulated papillomatosis is a disorder that presents in adolescence and appears to be more frequent in patients who are Black, obese, or overweight, and also have acanthosis nigricans. Clinicians should assess patients with confluent and reticulated papillomatosis for comorbidities, particularly those associated with insulin resistance, which may help reduce long-term disease burden.
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Affiliation(s)
- Teresa L Xiao
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Grace Y Duan
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Sarah L Stein
- Section of Dermatology, Department of Medicine and Pediatrics, University of Chicago Medical Center, Chicago, IL, USA
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Karadag AS, Uzuncakmak TK, Ozlu E, Takir M, Karadag R, Kostek O, Simsek M, Akdeniz N, Wollina U, Chen W. Introduction of a novel quantitative scoring system for acanthosis nigricans and its validation in a pilot study. Dermatol Ther 2020; 33:e14450. [PMID: 33103332 DOI: 10.1111/dth.14450] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/01/2020] [Accepted: 10/23/2020] [Indexed: 12/30/2022]
Abstract
Inconsistent data exist regarding the diagnostic value of acanthosis nigricans (AN) or skin tags as clinical markers for obesity or diabetes. In an outpatient department-based prospective study, we designed a scoring for AN severity (SCANS) to evaluate AN and skin tags, their correlation with obesity or diabetes. Quantification of AN in six anatomic sites, in consideration of the affected skin surface areas, texture changes, number of skin tags, leads to a total severity score between 0 and 46. Among 336 adult patients (aged ≥18 years) with AN, a higher BMI was associated with AN (r = 0.299, P < .001), but not with diabetes (P = .43), as compared with 243 age- and sex-matched controls without AN. Among nondiabetics, AN scores were significantly correlated with waist circumference (r = 0.131, P = .024) and total cholesterol levels (r = 0.155, P = .04). Skin tags alone in the absence of AN were not associated with obesity (P = .333) or diabetes (P = .164). The total AN scores were positively correlated with the presence of skin tags (r = 0.132, P < .001), and the involvement of anterior neck (r = 0.668, P < .001) and axilla (r = 0.793, P < .001). Knuckles and groins were unaffected in our series. Our results indicate that combination of AN with skin tags can be used as clinical marker for obesity, but not for diabetes. Large-scale studies on patients of different ethnic background are required to further validate our proposed scoring.
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Affiliation(s)
- Ayse Serap Karadag
- Department of Dermatology, Goztepe Research and Training Hospital, Istanbul, Turkey
| | | | - Emin Ozlu
- Department of Dermatology, Duzce University School of Medicine, Duzce, Turkey
| | - Mumtaz Takir
- Department of Endocrinology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Remzi Karadag
- Department of Ophthalmology, Veni Vidi Eye Clinic, Istanbul, Turkey
| | - Osman Kostek
- Department of Internal Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Mehmet Simsek
- Department of Dermatology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Necmettin Akdeniz
- Department of Dermatology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University, Dresden, Germany
| | - WenChieh Chen
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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Köseoğlu HG, Bozca BC, Başsorgun Cİ, Sarı R, Akbaş SH, Karakaş AA. The role of insulin-like growth factor in Acrochordon Etiopathology. BMC DERMATOLOGY 2020; 20:14. [PMID: 33143702 PMCID: PMC7640457 DOI: 10.1186/s12895-020-00111-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 10/26/2020] [Indexed: 11/10/2022]
Abstract
Background There are reports that acrochordon (skin tag), the most common fibroepithelial tumor of the skin, may be associated with metabolic syndrome components, particularly insulin metabolism disorders. However, to the best of our knowledge, there is no study examining its association with insulin resistance and tissue levels of insulin-like growth factor 1 receptor (IGF-1R) and insulin-like growth factor 2 receptor (IGF-2R). Methods Thirty patients with at least one acrochordon in their body who had no known history of diabetes mellitus and a control group comprised 30 individuals who had no acrochordon or no known history of diabetes mellitus were included. The tissue expression of IGF-1R and IGF-2R were investigated via immunohistochemical assessment in both groups. Results In the group with acrochordon, IGF-1R and IGF-2R expression was found to be significantly higher compared to the control group (p < 0,01). Using logistic regression analysis, an increase in serum insulin, serum IGF-1 and HOMA-IR levels was found to be associated with the expression levels of IGF-1R and IGF-2R. Conclusion These findings support the view that insulin metabolism disorders should be evaluated in patients with acrochordon. Our study indicates that IGF receptors may have an effect on acrochordon pathogenesis and that acrochordon etiology and related conditions can be clarified by detection of parameters that influence receptor levels.
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Affiliation(s)
| | - Burçin Cansu Bozca
- Dermatology and Venereology Department, Akdeniz University School of Medicine, Antalya, Turkey.
| | | | - Ramazan Sarı
- Endocrinology and Metabolism Department, Akdeniz University School of Medicine, Antalya, Turkey
| | - Sadıka Halide Akbaş
- Biochemistry Department, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ayşe Akman Karakaş
- Dermatology and Venereology Department, Akdeniz University School of Medicine, Antalya, Turkey
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Giant Fibroepithelial Polyps: Why do they Grow Excessively? MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2020; 54:257-260. [PMID: 32617069 PMCID: PMC7326686 DOI: 10.14744/semb.2018.33603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/23/2018] [Indexed: 01/05/2023]
Abstract
Fibroepithelial polyps (acrochordon or skin tag) are benign tumors that usually occur in skin folds, such as the axilla, genital area or neck. They can be solitary or multiple. Their dimensions usually do not exceed 1-2 millimeters. Sometimes, they can reach huge dimensions. In the literature, a giant fibroepithelial polyp with a size of 42 centimeters has been reported. Although the etiology and the factors that cause excessive growth have not been elucidated, it is stated that obesity and insulin resistance might trigger growth. Lymphedematous fibroepithelial polyps described in recent years show that prolonged lymphatic stasis and chronic inflammation may lead to the growth of fibroepithelial polyps. We present a 21-year-old patient with a giant fibroepithelial polyp with a size of 14x6 centimeter, located in the midline on the anterior chest wall. To our knowledge, this is the first case in the literature, in this location, which makes our case unique. Herein, we presented our patient along with the review of current literature pertaining to the diagnosis and the treatment of fibroepithelial polyps (FEPs) and the factors leading to excessive growth.
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Singh SK, Agrawal NK, Vishwakarma AK. Association of Acanthosis Nigricans and Acrochordon with Insulin Resistance: A Cross-Sectional Hospital-Based Study from North India. Indian J Dermatol 2020; 65:112-117. [PMID: 32180596 PMCID: PMC7059470 DOI: 10.4103/ijd.ijd_646_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Insulin resistance (IR) is a pre-diabetic condition and has been reported in patients with acanthosis nigricans (AN) and acrochordon. AN and acrochordon are claimed to be cutaneous markers of IR. Aim The purpose of this paper was to study the association of AN and acrochordon with IR. Methods It was a cross-sectional hospital-based study. Both groups were assessed for IR by using homeostatic model assessment of insulin resistance (HOMA-IR) formula. Results A total of 70 cases and an equal number of controls were studied. IR was observed more in cases (41.4%) compared to controls (17.1%) (P < 0.01). Mean HOMA-IR value was also significantly higher in cases (4.32 ± 4.44) compared to controls (2.27 ± 0.90) (P < 0.05). Limitations Low number of cases and controls were taken in the study. Association with hyperlipidemia and metabolic syndrome was not elicited. Conclusions AN and acrochordons were found to be associated with IR.
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Affiliation(s)
- Satyendra K Singh
- Department of Dermatology and Venereology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Neeraj K Agrawal
- Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ajay K Vishwakarma
- Department of Dermatology and Venereology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Farag AGA, Abdu Allah AMK, El-Rebey HS, Mohamed Ibraheem KI, Mohamed ASED, Labeeb AZ, Elgazzar AE, Haggag MM. Role of insulin-like growth factor-1 in skin tags: a clinical, genetic and immunohistochemical study in a sample of Egyptian patients. Clin Cosmet Investig Dermatol 2019; 12:255-266. [PMID: 31118729 PMCID: PMC6503204 DOI: 10.2147/ccid.s192964] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/05/2019] [Indexed: 12/23/2022]
Abstract
Background: Skin tags (STs) are benign connective tissue neoplasms, in which insulin-like growth factor −1 (IGF-1) has a mitogenic and antiapoptotic activity. Purpose: We aimed to study for the first time, the possible role of IGF-1 (CA) 19 and rs6214 gene polymorphisms, and its tissue immunoreactivity in the pathogenesis of STs. Patients and methods: This case–control study included 40 ST patients and 20 controls. We searched for (CA) 19 single-nucleotide polymorphism (SNP) using conversional PCR and for rs6214 gene polymorphism using real-time PCR. IGF-1 tissue immunoreactivity was investigated using polyclonal IGF-1 antibody. Results: IGF-1 immunoreactivity showed significantly strong upregulation in epidermis (p=0.002) and dermal components (endothelial cells [p=0.038] and fibroblasts [p=0.004]) of excised STs than control skin. TT and CT rs6214 genotypes and its T allele were significantly associated with STs (p=0.006 and P=0.002, respectively). Also (<192 bp) and 192–194 bp (CA) 19 genotypes were significantly predominant in ST patients than controls (p=0.013). These 4 genotypes were significantly associated with development of multiple STs and epidermal IGF-1 tissue immunoreactivity in studied patients. Conclusions: IGF-1 (CA) 19 and rs6214 gene polymorphisms may contribute to a predisposition of STs in Egyptian patients, the role of which could be mediated through local upregulation of IGF-1 in cutaneous tissues.
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Affiliation(s)
- Azza Gaber Antar Farag
- Department of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufia University, Shibīn al Kawm, Egypt
| | | | - Hala Said El-Rebey
- Department of Pathology, Faculty of Medicine, Menoufia University, Shibīn al Kawm, Egypt
| | - Kawthar Ibraheem Mohamed Ibraheem
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.,Microbiology Department, Taibah University, Medina, Kingdom of Saudi Arabia
| | | | - Azza Zaghlol Labeeb
- Department of Microbiology, Faculty of Medicine, Menoufia University, Shibīn al Kawm, Egypt
| | - Ayman Elhussien Elgazzar
- Department of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufia University, Shibīn al Kawm, Egypt
| | - Magda Mostafa Haggag
- Department of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufia University, Shibīn al Kawm, Egypt
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Mendes AL, Miot HA, Haddad V. Diabetes mellitus and the skin. An Bras Dermatol 2017; 92:8-20. [PMID: 28225950 PMCID: PMC5312172 DOI: 10.1590/abd1806-4841.20175514] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 06/29/2016] [Indexed: 11/22/2022] Open
Abstract
Several dermatoses are routinely associated with diabetes mellitus, especially in patients with chronic disease. This relationship can be easily proven in some skin disorders, but it is not so clear in others. Dermatoses such necrobiosis lipoidica, granuloma annulare, acanthosis nigricans and others are discussed in this text, with an emphasis on proven link with the diabetes or not, disease identification and treatment strategy used to control those dermatoses and diabetes.
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Affiliation(s)
- Adriana Lucia Mendes
- Department of Clinical Medicine - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil
| | - Helio Amante Miot
- Department of Dermatology and Radiotherapy - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP) -Botucatu (SP), Brazil
| | - Vidal Haddad
- Department of Dermatology and Radiotherapy - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP) -Botucatu (SP), Brazil
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Jusuf NK, Putra IB, Kartayana J. The Correlation between Body Mass Index with the Occurrence of Skin Tag. Open Access Maced J Med Sci 2017; 5:271-274. [PMID: 28698740 PMCID: PMC5503720 DOI: 10.3889/oamjms.2017.061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/24/2017] [Accepted: 04/21/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND: Skin tag is a benign tumour of the skin with a soft consistency which commonly occurs in the flexure area. Skin tag often found in individuals with middle and old age. Until now, there are many of theories have been proposed to explain the mechanism of the skin tag, one of the theory is obesity. AIM: To determine the body mass index (BMI) in patients with skin tag. METHODS: This study is an analytic study with cross-sectional designs involving 32 subjects with skin tag and 32 controls. Diagnosis of skin tag was made based on anamnesis and clinical examination. All subjects underwent a physical examination (height and weight) to determine BMI (weight in kilogrammes divided by the square of height in meters). To analyse association between higher BMI with the occurrence of skin tag we use student t-test. RESULTS: The mean BMI in the skin tag group (28.1+ 3.9 kg/m^2) was higher compared with the control group (24.1 + 2.3 kg/m^2). Statistical analysis by Student t-test found the p-value < 0.05. CONCLUSION: We found a correlation between increased BMI with the occurrence of the skin tag.
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Affiliation(s)
- Nelva K Jusuf
- Department Dermatovenereology, Faculty of Medicine, University of Sumatera Utara, Medan 20155, Indonesia
| | - Imam B Putra
- Department Dermatovenereology, Faculty of Medicine, University of Sumatera Utara, Medan 20155, Indonesia
| | - Johan Kartayana
- Department Dermatovenereology, Faculty of Medicine, University of Sumatera Utara, Medan 20155, Indonesia
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Purim KSM, Titski ACK, Leite N. Dermatological aspects influencing the practice of physical activities by obese individuals. FISIOTERAPIA EM MOVIMENTO 2015. [DOI: 10.1590/0103-5150.028.004.ar02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective : The aim of this study was to perform a systematic review of the major skin diseases affecting obese individuals and their influence on physical activity. Methods : Relevant articles were identified by systematically searching PubMed from 2000 to 2014, using the descriptors "skin diseases" and "obesity", "skin disease" and "obesity", "skin diseases" and "physical activity", "skin disease" and "physical activity". The PEDro Scale (in Brazilian Portuguese) was used to rate the methodological quality of the studies. Results : A total of 320 articles were examined in the first phase. In the end, 11 articles met the proposed criteria and were included for analysis in the systematic review. We investigated cutaneous manifestations of diseases and classified them according to their effects under 5 categories: metabolic (n = 10), aesthetic (n = 7), inflammatory (n = 6), mechanical (n = 5) and infectious (n = 3). The most frequent dermatoses among obese were acanthosis nigricans, acrochordon (skin tags), stretch marks, plantar keratodermia, intertrigo, bacterial and fungal infections. Acanthosis nigricans was found to be the most important metabolic implication of obesity. Conclusion : Although neglected, skin lesions are common in obesity and have implications for physical activity because they cause pain, discomfort, friction, infection, inflammation, embarrassment, limitation or difficulty of movement. Strategies to promote skin health may result in a better integration of physical activity into routine therapy and improve the quality of life of obese individuals.
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Alkhalili E, Prapasiri S, Russell J. Giant acrochordon of the axilla. BMJ Case Rep 2015; 2015:bcr-2015-210623. [PMID: 26142392 DOI: 10.1136/bcr-2015-210623] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Acrochordons or fibroepithelial polyps, are very common skin lesions. However, giant acrochordons are extremely rare. We present a case of a morbidly obese diabetic man who was treated with primary excision of a giant 18 cm acrochordon of the left axilla.
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Affiliation(s)
- Eyas Alkhalili
- Department of Surgery, University of New Mexico, Albuquerque, New Mexico, USA
| | - Surasri Prapasiri
- School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - John Russell
- Department of Surgery, University of New Mexico, Albuquerque, New Mexico, USA
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Knaś M, Wołosik K, Zalewska A, Mikucka-Niczyporuk A, Kasacka I, Niczyporuk M. The skin remodeling in type 1 diabetes and insulin resistance animal models. Physiol Res 2015; 64:875-81. [PMID: 26047379 DOI: 10.33549/physiolres.932991] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The skin matrix metalloproteinase 3, tissue inhibitors of matrix metalloproteinase 2 and collagen III content changes in type 1 diabetes and insulin resistance treated with insulin and metformin were studied. Healthy adult male Wistar rats were obtained from experimental animal house, Department of Experimental Pharmacology, Medical University in Bialystok. The rats were divided randomly into five groups of 8 rats each. Control rats were injected intraperitoneally by NaCl. Type IDDM was induced by a single injection of Streptozocin. Insulin resistance was induced by a high-fat diet. The chosen groups of rats were also treated with insulin or metformin. ELISA Kits (USCN Life Science, China) were used to measure content of matrix metallo-proteinase 3 (ELISA Kit for Matrix Metalloproteinase 3 - MMP3), tissue inhibitor of matrix metalloproteinase 2 (ELISA Kit for Tissue Inhibitors of Metalloproteinase 2 - TIMP2) and content of collagen type 3 (ELISA Kit for Collagen Type III - COL3). The results were reported as a median. The statistical significance was defined as p<0.05. Type 1 diabetes and insulin resistance have significantly reduced the quality of the skin, shown by the increase in content of matrix metalloproteinase 3 and the decrease in content of tissue inhibitors of matrix metalloproteinase 2. Type 1 diabetes and insulin resistance have reduced the quality of the skin expressed by type III collagen content decrease but for future studies it is recommend to determine rat interstitial collagenase, MMP-13, as well. Insulin and metformin treatment improved the quality of the diabetic skin, demonstrated by the type III collagen content increase.
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Affiliation(s)
- M Knaś
- Institute of Health Care, Higher Vocational School, Suwalki, Poland; Research Laboratory of Cosmetology, Medical University of Bialystok, Poland.
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Idris S, Sunitha S. Assessment of BMI, Serum Leptin Levels and Lipid Profile in Patients with Skin Tags. J Clin Diagn Res 2014; 8:CC01-3. [PMID: 25386426 DOI: 10.7860/jcdr/2014/10350.4853] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 08/13/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Skin tags (ST) are benign lesions composed of loose fibrous tissue, associated with obesity and atherogenic profile. Thus help in the follow up by considering ST as a useful cutaneous sign for the risk factor of atherosclerosis. AIM To evaluate the association of skin tags with BMI, serum leptin and lipid profile. MATERIALS AND METHODS The study was carried out in 40 cases with ST and 40 age and gender matched controls. Subjects on oral contraceptives and systemic drugs especially lipid lowering agents, pregnant women, cases with medical history of endocrine disease, acute infection, erythroderma and psoriasis, cases with a drug history of isotretinoin use in last six months were excluded from the study. Blood samples were collected. Serum lipids and serum leptin were estimated. RESULT The acrochordons group showed significantly higher values of BMI, total cholesterol (TC) and TC/HDL ratio. 60% of the patients with ST were overweight and 10% were obese. There was no statistical significant difference in leptin levels between the groups. Leptin showed a positive significant correlation with BMI in the acrochordons group. CONCLUSION All the above derangements confirm that ST is cutaneous findings frequently associated with obesity and dyslipidemia. Thus follow-up of these patients with regard to the development of diseases associated with atherosclerosis may be beneficial.
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Affiliation(s)
- Sadaf Idris
- Tutor, Department of Biochemistry, Kempegowda Institute of Medical Sciences , Bangalore, India
| | - S Sunitha
- Associate Professor, Department of Biochemistry, Kempegowda Institute of Medical Sciences , Bangalore, India
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Bernardes Filho F, Quaresma MV, Rezende FC, Kac BK, Nery JADC, Azulay-Abulafia L. Confluent and reticulate papillomatosis of Gougerot-Carteaud and obesity: dermoscopic findings. An Bras Dermatol 2014; 89:507-9. [PMID: 24937831 PMCID: PMC4056715 DOI: 10.1590/abd1806-4841.20142705] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 06/26/2013] [Indexed: 11/23/2022] Open
Abstract
Confluent and reticulated papillomatosis of Gougerot and Carteaud is a dermatosis
that despite showing characteristic clinical signs is often poorly recognized
and diagnosed. The authors present a case with extensive skin involvement,
discuss its association with obesity and describe dermoscopic findings making
the histopathological correlation.
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Affiliation(s)
| | | | | | - Bernard Kawa Kac
- Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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El Safoury OS, Ezzat M, Abdelhamid MF, Shoukry N, Badawy E. The Evaluation of the Impact of Age, Skin Tags, Metabolic Syndrome, Body Mass Index, and Smoking on Homocysteine, Endothelin-1, High-sensitive C-reactive Protein, and on the Heart. Indian J Dermatol 2013; 58:326. [PMID: 23919019 PMCID: PMC3726896 DOI: 10.4103/0019-5154.113947] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Skin tags (STs) are small, pedunculated skin-colored or brown papules that occur around any site where skin folds occur. The literature is short of comprehensive and controlled clinical studies aimed to evaluate the atherogenic risk factors in patients with STs. AIM OF WORK The aim of this study is to evaluate the impact of age, STs, metabolic syndrome (METs), body mass index (BMI), and smoking on homocysteine (Hcy), endothelin-1 (ET-1), high-sensitive C-reactive protein (Hs-CRP), and on cardiovascular diseases. MATERIALS AND METHODS This study included 30 cardiac patients with STs, 30 non-cardiac patients with STs, and 30 healthy controls with neither heart disease nor STs. History of smoking, measurement of height, weight, BMI, waist circumference (WC), blood pressure, STs number, color, acanthosis nigricans, estimation of serum level of fasting glucose, triglycerides (TGs), cholesterol, high-dense lipoproteins (HDL), Hcy, ET-1, Hs-CRP, and the presence of the METs were elicited in the three groups. RESULTS Regarding the Hcy, ET-1, and Hs-CRP, the cardiac-STs group showed the highest levels and the control group showed the least (P < 0.001). The percents of patients with METs were 56.7% in the cardiac-STs, 40% in the non-cardiac-STs, and 0% in the control group (P < 0.001). Mean BMI exceeded the limit of obesity in the cardiac-STs group (30.9 ± 3.9) and the non-cardiac-STs group (32.6 ± 6) and was normal in the control group (24.7 ± 2.8). Hyperpigmented STs were present in 66.7% of the cardiac-STs group. Multivariate regression analysis for the independent effectors on Hcy level were the presence of STs (P < 0.001), METs (P = 0.001), and BMI (P = 0.024). Regarding ET-1, the effectors were the presence of STs and METs (P = 0.032). For Hs-CRP, effectors were the presence of STs (P < 0.001) and smoking (P = 0.040). Multivariate logistic regression of the predictors of cardiac disease showed that the independent predictors of the occurrence of cardiac disease were BMI (P < 0.001), STs (P = 0.002), and METs (P = 0.037). CONCLUSION STs may act as a physical sign of underlying raised cardiac atherogenic factors. This may indicates an ongoing risk on coronary circulation which may indicate further corrective action, hopefully early enough. The association of ST with obesity and METs represents a Bermuda Triangle that act against the heart.
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17
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Resende M, Bolfi F, Nunes VDS, Miot HA. Prevalence of dermatologic disorders in 15 patients with acromegaly. An Bras Dermatol 2012; 87:166-8. [PMID: 22481676 DOI: 10.1590/s0365-05962012000100031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Accepted: 12/27/2010] [Indexed: 11/22/2022] Open
Abstract
Acromegaly is a chronic, insidious and rare disease, caused by hyper secretion of the growth hormone, which metabolic and trophic effects commonly result in cutaneous manifestations, sometimes preceding other clinical symptoms. The authors have assessed 15 patients with acromegaly and found dermatologic lesions in all of them, mainly skin thickening, acrochordons, epidermoid cysts, pseudoacanthosis nigricans, seborrheic keratosis, melanocytic naevi and lentiginous spots.
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Affiliation(s)
- Mariângela Resende
- Dermatology and Radiology Department, Universidade Estadual Paulista "Julio de Mesquita Filho", Botucatu, SP, Brasil
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18
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Barbato MT, Criado PR, Silva AKD, Averbeck E, Guerine MB, Sá NBD. Association of acanthosis nigricans and skin tags with insulin resistance. An Bras Dermatol 2012; 87:97-104. [DOI: 10.1590/s0365-05962012000100012] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2011] [Accepted: 03/13/2011] [Indexed: 11/22/2022] Open
Abstract
Insulin resistance is a metabolic disorder in which target cells fail to respond to normal levels of circulating insulin. Insulin resistance has been associated with presence of acanthosis nigricans and acrochordons. It is known that early diagnosis and early initial treatment are of paramount importance to prevent a series of future complications. These dermatoses may represent an easily identifiable sign of insulin resistance and non-insulin-dependent diabetes.
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Yoneda PDP, Biancolin SE, Gomes MSM, Miot HA. Associação entre espessura da pele e densidade óssea em mulheres adultas. An Bras Dermatol 2011; 86:878-84. [DOI: 10.1590/s0365-05962011000500003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Accepted: 11/20/2010] [Indexed: 11/22/2022] Open
Abstract
FUNDAMENTOS: Osteoporose acomete principalmente mulheres em menopausa e idosos, predispondo a fraturas que geram morbidade, mortalidade e custos ao sistema de saúde. Como o colágeno dérmico diminui paralelamente à redução da massa óssea com o envelhecimento, a medida da espessura da pele pode ser indício do risco de osteoporose. OBJETIVOS: Avaliar a correlação entre densidade óssea e espessura da pele do dorso das mãos de mulheres adultas. MÉTODOS: Estudo transversal envolvendo mulheres adultas atendidas em ambulatório de hospital universitário submetidas à densitometria óssea, que foram avaliadas individualmente e mensurada, por paquímetro, a espessura da pele no dorso das mãos, além de investigados demais fatores de risco para osteoporose. RESULTADOS: Avaliaram-se 140 pacientes. A média (±dp) de idade foi de 57 (±11) anos; a média da espessura da pele do dorso das mãos foi de 1,4 (±0,4) mm. Houve correlação entre as medidas das mãos direita e esquerda (R=0,9; p<0,01). Observou-se correlação direta entre as espessuras de pele do dorso das mãos e as densidades ósseas lombares e femorais (p<0,01). Tais resultados permaneceram consistentes mesmo quando ajustados pelas covariáveis: idade, fototipo, índice de massa corpórea, tabagismo, uso de corticoide oral, uso de anti-inflamatório oral e tempo de menopausa. Osteoporose se associou inversamente com a espessura da pele das mãos (Odds Ratio=0,10; p<0,03). CONCLUSÃO: Espessura da pele correlacionou-se, independentemente, com a densidade óssea, sugerindo simultaneidade dos eventos. Sinais cutâneos podem contribuir para a estratificação de risco não invasiva desses pacientes, e colaborar na identificação e tratamentos precoces
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