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Bomar L, Lewallen R, Jorizzo J. Localized acanthosis nigricans at the site of repetitive insulin injections. Cutis 2020; 105:E20-E22. [PMID: 32186539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Leonora Bomar
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Robin Lewallen
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Joseph Jorizzo
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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2
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Morton A, Menon A, O'Moore-Sullivan T. A young African woman with hyperglycaemia. Aust Fam Physician 2016; 45:206-207. [PMID: 27052137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Adam Morton
- FRACP, is Senior Staff Specialist, Endocrinology and Obstetric Medicine, Mater Hospital, Brisbane, Queensland
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Yahagi E, Mabuchi T, Nuruki H, Manabe Y, Ikoma N, Ozawa A, Yamamoto N, Tanaka E, Sekido Y, Matsuyama T. Case of exogenous insulin-derived acanthosis nigricans caused by insulin injections. Tokai J Exp Clin Med 2014; 39:5-9. [PMID: 24733591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 01/09/2014] [Indexed: 06/03/2023]
Abstract
A 73-year-old male with diabetes mellitus had been treated with insulin for six years. He developed a solid mass on his left lateral of the abdomen at the insulin injection site. A firm subcutaneous mass with dark-red erythema was overlaid by dark-brown keratinized plaques. On histological examination of the mass, keratin proliferation and epidermal papilloma were observed. There were four previously reported cases of acanthosis nigricans that were considered to be caused by continuous injections of insulin. Using immunohistochemistry, in our case the findings were positive in the basal epithelial and prickle cell layers when the patient's lesion was dyed with insulin-like growth factor (IGF)-1 antibody. The coexistence of dermal IGF-1 receptor and acanthosis nigricans found in our patient has not been reported previously, to our knowledge.
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Affiliation(s)
- Eiichiro Yahagi
- Department of Dermatology, Tokai University Hachioji Hospital, 1838 Ishikawamachi, Hachioji, Tokyo 192-0032, Japan.
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Peña Irún A. [Acral acanthosis nigricans associated with taking growth hormone]. Semergen 2013; 40:e77-9. [PMID: 23746703 DOI: 10.1016/j.semerg.2013.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Revised: 03/18/2013] [Accepted: 03/19/2013] [Indexed: 11/19/2022]
Abstract
Acanthosis nigricans is a skin lesion characterized by the presence of a hyperpigmented, velvety cutaneous thickening that usually appears in flexural areas. Less frequently, it can occur in other locations, such as the dorsum of hands and feet. In this case it is called acral acanthosis nigricans. It is a dermatological manifestation of systemic disease. It is often associated with insulin resistance-mediated endocrine diseases. A case is presented on a patient with acanthosis nigricans secondary to the use of growth hormone.
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Affiliation(s)
- A Peña Irún
- Medicina de Familia y Comunitaria, Centro de Salud Sardinero, Santander, Cantabria, España.
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Buzási K, Sápi Z, Jermendy G. Acanthosis nigricans as a local cutaneous side effect of repeated human insulin injections. Diabetes Res Clin Pract 2011; 94:e34-6. [PMID: 21839533 DOI: 10.1016/j.diabres.2011.07.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 07/18/2011] [Indexed: 10/17/2022]
Abstract
Acanthosis nigricans is a hyperkeratotic lesion of the epidermis associated with insulin resistance. We present a diabetic patient with acanthosis nigricans at the insulin injection site on the abdominal wall. Neglecting rotation of sites for insulin injections and local hyperinsulinemia may play a role in the development of acanthosis nigricans.
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Affiliation(s)
- Katalin Buzási
- Department of Endocrinology and Angiology, Bajcsy-Zsilinszky Hospital, Maglódi út 89-91, Budapest 1106, Hungary
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Hartman R, Defelice T, Tzu J, Meehan S, Sanchez M. Acanthosis nigricans in the setting of niacin therapy. Dermatol Online J 2011; 17:11. [PMID: 22031637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
We report the case of a 63-year-old obese man with a rapid-onset of widespread acanthosis nigricans (AN) in the setting of having recently initiated treatment with niacin for dyslipidemia. Although obesity and insulin-resistance are risk factors for AN, AN associated with endocrine dysfunction tends to have a more gradual onset and limited involvement. Owing to our patient's age, the rapid onset, and extensive distribution of his eruption, we initially were concerned about paraneoplastic AN. However, an evaluation for a malignant condition was negative. The timing of the onset of our patient's eruption within several months of starting niacin therapy is consistent with niacin-induced AN. Niacin is known to cause rapidly progressive, widespread AN that is reversible upon discontinuation of the medication. We discuss the pathogenesis of AN, which is thought to be the final common manifestation of stimulation of different subtypes of tyrosine kinase receptors by various epidermal growth factors.
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Affiliation(s)
- Rachael Hartman
- Department of Dermatology, New York University, New York, New York, USA
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Lee M, Grassi M. Acanthosis nigricans in a patient treated with palifermin. Cutis 2010; 86:136-137. [PMID: 21049730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Palifermin is a modified human keratinocyte growth factor (KGF) given to decrease the incidence and duration of severe oral mucositis in patients receiving myelotoxic chemotherapy followed by a hematopoietic stem cell transplant. We report a case of a 42-year-old man who developed acanthosis nigricans after taking palifermin.
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Affiliation(s)
- Melvin Lee
- Department of Dermatology, The State University of New York, Buffalo, USA
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Affiliation(s)
- S W Lane
- Department of Haematology, Princess Alexandra Hospital, School of Medicine, University of Queensland, Queensland, Australia
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Mur A, Seidel V, López-Vílchez MA, Bonet M, Gilaberte M. Acanthosis nigricans as an adverse effect of highly active antiretroviral therapy in an adolescent girl with human immunodeficiency virus infection. Pediatr Infect Dis J 2005; 24:742-3. [PMID: 16094236 DOI: 10.1097/01.inf.0000172936.20623.fd] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We report an 11-year-old girl with acanthosis nigricans that appeared after 4 years of treatment with didanosine, stavudine and amprenavir. Laboratory studies showed hyperglycemia, hyperinsulinemia and hypertriglyceridemia. Withdrawal of amprenavir resulted in disappearance of acanthosis nigricans and improvement of metabolic abnormalities.
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Affiliation(s)
- Antonio Mur
- Service of Pediatrics, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
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Abstract
As dietary sources of gamma-linolenic acid [GLA; 18:3(n-6)], borage oil (BO; 24-25 g/100 g GLA) and evening primrose oil (PO; 8-10 g/100 g GLA) are efficacious in treating skin disorders. The triglycerol stereospecificity of these oils is distinct, with GLA being concentrated in the sn-2 position of BO and in the sn-3 position of PO. To determine whether the absolute level and/or the triglycerol stereospecificity of GLA in oils affect biological efficacy, epidermal hyperproliferation was induced in guinea pigs by a hydrogenated coconut oil (HCO) diet for 8 wk. Subsequently, guinea pigs were fed diets of PO, BO or a mixture of BO and safflower oil (SO) for 2 wk. The mixture of BO and SO (BS) diet had a similar level of GLA as PO but with sn-2 stereospecificity. As controls, two groups were fed SO and HCO for 10 wk. Epidermal hyperproliferation was reversed by all three oils in the order of BO > BS > PO. However, proliferation scores of group PO were higher than of the normal control group, SO. The accumulations of dihomo-gamma-linolenic acid [DGLA; 20:3(n-6)], an elongase product of GLA, into phospholipids and ceramides, of 15-hydroxyeicosatrienoic acid (15-HETrE), the potent antiproliferative metabolite of DGLA, and of ceramides, the major lipid maintaining epidermal barrier, in the epidermis of group BO were greater than of groups BS and PO. Group BS had higher levels of DGLA, 15-HETrE and ceramides than group PO. With primary dependence on absolute levels, our data demonstrate that the antiproliferative efficacy of GLA in the epidermis is preferably exerted from sn-2 stereospecificity of GLA in BO.
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Affiliation(s)
- S Chung
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Seoul, Korea
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Ozerdem U, Levi L, Cheng L, Song MK, Scher C, Freeman WR. Systemic toxicity of topical and periocular corticosteroid therapy in an 11-year-old male with posterior uveitis. Am J Ophthalmol 2000; 130:240-1. [PMID: 11004305 DOI: 10.1016/s0002-9394(00)00501-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To report a case of systemic corticosteroid toxicity resulting from topical and periocular therapy. METHODS Treatment and follow-up of an 11-year-old male with uveitis are illustrated. Initial presentation of the patient was bilateral iridocyclitis, for which he was treated with prednisolone acetate 1% every 2 hours for 6 months. Subsequently, posterior uveitis developed, necessitating posterior subtenon injections. RESULTS After initial topical corticosteroid therapy, the patient developed a cushingoid habitus accompanied by increased lanugo hair, acanthosis nigricans, posterior subcapsular lens opacities, and increased intraocular pressure. Cushingoid stigmata worsened after administration of posterior subtenon injection of corticosteroids. The patient's truncal obesity worsened, and his linear growth stopped. CONCLUSIONS Systemic toxic effects may develop as a result of topical and local use of ophthalmic corticosteroid preparations in susceptible patients.
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Affiliation(s)
- U Ozerdem
- Shiley Eye Center, University of California, San Diego, La Jolla, California 92093-0946, USA
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Abstract
Drug-induced acanthosis nigricans has been reported in the literature. We present a patient with familial combined hyperlipidemia who developed nicotinic-acid-induced acanthosis nigricans. The literature on the cutaneous side effects of nicotinic acid as well as on the medications that can cause acanthosis nigricans is reviewed. Some hypotheses on the pathogenesis of nicotinic-acid-induced acanthosis are presented.
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Affiliation(s)
- H Stals
- Department of Dermatology, University Hospital, Leuven, Belgium
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Affiliation(s)
- A Teknetzis
- Department of Dermatology, Aristotle University School of Medicine, Thessaloniki, Greece
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Abstract
BACKGROUND beta-Blockers cause a psoriasiform eruption. We investigated the skin effects of systemic propranolol in a formal protocol. METHODS Propranolol, 0.1 mg/day, was used systemically by gavage in eight albino guinea pigs. Normal saline was given to another group of seven guinea pigs. RESULTS Propranolol produced psoriasiform lesions in five of seven guinea pigs on the 30th day. Biopsies showed acanthosis, parakeratosis, microabscesses, and cellular infiltration of upper dermis. Topical application of propranolol did not produce clinical psoriasiform changes, while acanthosis and papillomatosis was observed in six of the six guinea pigs.
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Affiliation(s)
- B Tüzün
- University of Istanbul, Experimental Medicine Research and Application Center (DETAM), Turkey
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Coates P, Shuttleworth D, Rees A. Resolution of nicotinic acid-induced acanthosis nigricans by substitution of an analogue (acipimox) in a patient with type V hyperlipidaemia. Br J Dermatol 1992; 126:412-4. [PMID: 1571266 DOI: 10.1111/j.1365-2133.1992.tb00692.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- P Coates
- Department of Medicine, University Hospital of Wales, Cardiff, U.K
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Appeltauer LC. Megavitamin and megamineral therapy in childhood. CMAJ 1991; 145:104-5. [PMID: 1860099 PMCID: PMC1335587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Katzenelson V, Ginzburg A, Sandbank M. [Etiology of acanthosis nigricans]. Med Clin (Barc) 1988; 91:671-4. [PMID: 3068434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Sherertz EF. Improved acanthosis nigricans with lipodystrophic diabetes during dietary fish oil supplementation. Arch Dermatol 1988; 124:1094-6. [PMID: 3389852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Acanthosis nigricans is well recognized in its clinical association with several types of insulin-resistant syndromes, and skin involvement is usually unresponsive to local treatment or management of diabetes. A young woman with a lipodystrophic form of diabetes, hypertriglyceridemia, and severe generalized acanthosis nigricans was placed on a diet with fat supplementation in the form of omega-3-fatty-acid-rich fish oil. She was observed to have striking improvement in the appearance and extent of acanthosis nigricans while receiving this regimen. This occurred despite continued therapy with niacin (nicotinic acid), an agent associated with acanthosis nigricanslike skin changes.
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Affiliation(s)
- E F Sherertz
- Veterans Administration Medical Center, Gainesville
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Shuttleworth D, Weavind GP, Graham-Brown RA. Acanthosis nigricans and diabetes mellitus in a patient with Klinefelter's syndrome: a reaction to methyltestosterone. Clin Exp Dermatol 1987; 12:288-90. [PMID: 3427814 DOI: 10.1111/j.1365-2230.1987.tb01924.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Holdiness MR. Acanthosis nigricans. Arch Dermatol 1985; 121:588. [PMID: 3888120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Papa CM. Niacinamide and acanthosis nigricans. Arch Dermatol 1984; 120:1281. [PMID: 6237615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Randle HW, Winkelmann RK. Steroid-induced acanthosis nigricans in dermatomyositis. Arch Dermatol 1979; 115:587-8. [PMID: 443833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Acanthosis nigricans of the groin, axillae, and neck developed in a patient on long-term steroid therapy for dermatomyositis after eight years. The dermatosis resolved spontaneously ten years after the steroid use had been discontinued. Review of three personal cases and the literature suggests that acanthosis nigricans may have a hormonal basis.
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Curth HO. Letter: Acanthosis nigricans following use of oral contraceptives. Arch Dermatol 1975; 111:1069. [PMID: 1232930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Abstract
A population of over 15,000 snuff users and tobacco chewers were observe for cytological, histological, and clinical evaluation. The original observation was for 5 1/2 years. The same group was observed for an additional 4 1/2 years, bringing the total time to ten years. Of the original group of 1,751 patients showing mucosal change, i was able to follow up 1,550. No patient developed carcinoma or serious mucosal changes. From this ten-year study we concluded that snuff, per se, or chewing do not act as carcinogens.
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Banuchi SR, Cohen L, Lorincz AL, Morgan J. Acanthosis nigricans following diethylstilbestrol therapy. Occurrence in patients with childhood muscular dystrophy. Arch Dermatol 1974; 109:545-6. [PMID: 4819110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Young AW, Rosenberg FR. Cutaneous stigmas of heroin addiction. Arch Dermatol 1971; 104:80-6. [PMID: 5120168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Fox H. Current concepts of acanthosis nigricans. Med Times 1970; 98:137-43. [PMID: 5454741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Rassner G. [Acanthosis]. Hautarzt 1969; 20:197-204. [PMID: 4902010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Brown J, Winkelmann RK. Acanthosis nigricans: a study of 90 cases. Medicine (Baltimore) 1968; 47:33-51. [PMID: 4868603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Branehög I, Hallén A. [Nicotinic acid--acanthosis nigricans]. Lakartidningen 1967; 64:1449-1451. [PMID: 6046636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Vanherle R, Maggiora A, Bujard E, Jadassohn W. [Acanthosis and sebaceous gland hypertrophy in guinea pigs]. Hautarzt 1966; 17:316-8. [PMID: 5992998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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