- Genetic factors
There are hereditary forms of acanthosis nigricans, such as benign acanthosis nigricans, which is inherited in an autosomal dominant pattern. Patients often have a family history. Genetic defects lead to abnormal proliferation of skin cells and changes such as hyperpigmentation.In pediatric patients with hereditary acanthosis nigricans, genetic factors should be considered if a similar family history exists. A detailed family history is important for diagnosis and disease assessment. - Endocrine factors
Related to insulin resistance:Acanthosis nigricans is common in obese individuals, mainly because obesity causes insulin resistance. Elevated insulin levels stimulate the proliferation of skin fibroblasts and keratinocytes, while promoting melanin synthesis, resulting in skin hyperpigmentation and thickening.For obese children or adults with acanthosis nigricans, insulin resistance is an important pathogenic mechanism, requiring monitoring of blood glucose, insulin levels and other indicators.
Other endocrine diseases:Acanthosis nigricans may also occur in patients with acromegaly due to excessive growth hormone secretion.Patients with hypothyroidism may present with acanthosis nigricans as a result of insufficient thyroid hormone and slowed metabolism.The manifestations and treatment of acanthosis nigricans vary with the underlying endocrine disease across different age groups. - Malignancy‑related factors
Certain malignant tumors, such as gastric cancer, lung cancer, and ovarian cancer, can be associated with acanthosis nigricans.The mechanism may involve tumor cells secreting substances similar to insulin‑like growth factor‑1 (IGF‑1), which stimulates skin cell proliferation and hyperpigmentation.The risk of different malignancies varies by age; for example, elderly patients have a relatively higher risk of acanthosis nigricans associated with malignant tumors.Comprehensive tumor screening, including imaging examinations, is recommended for adult patients with acanthosis nigricans.