Papillary-pigmentary dystrophy of the skin (black acanthosis)

Black acanthosis (dystrophy of the skin of the papillary-pigmentosa) is characterized by hyperkeratosis, hyperpigmentation and papillomatosis of the skin, axillae and other large folds.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10]

Causes Papillary-pigmentary dystrophy of the skin (black acanthosis)

Causes of papillary-pigmentary dystrophy of the skin

In the emergence of black acanthosis, the hereditary factor, endocrine diseases, obesity, malignant neoplasms play a role.

[11], [12], [13], [14], [15], [16], [17], [18]

Pathogenesis

Histopathology

Histologically, the epidermis shows pronounced papillomagosis, hyperkeratosis, small acapathy, and accumulation of pigment in all layers of the skin; in the dermis - pronounced papillomatosis, vasodilation; in the papillate layer - a moderate perivasquire lymphoid infiltrate.

Symptoms Papillary-pigmentary dystrophy of the skin (black acanthosis)

Symptoms of papillary-pigmentary dystrophy of the skin

There are the following clinical forms of the disease: benign (juvenile); not associated with endocrine, hereditary diseases and the tumor process; associated with endocrine and hereditary diseases; Malignant (paraneoplastic), which occurs in individuals with tumors of internal organs, and pseudoacanthosis.

Dermatosis manifests itself in childhood, the initial clinical signs are common for all types of disease. Dermatosis is characterized by the appearance of areas of hyperpigmentation, hyperkeratosis of the skin mainly in the armpits, inguinal and femoral folds, knee and elbow folds, as well as on the side surfaces of the neck, around the navel, etc. The skin is dry, brownish, then becomes black, , the relief coarsens, there are increased folding and papillomatous growths. Can be noted keratosis on the palms and soles, multiple fibroids, pigment spots like freckles. Hair and nails are often dystrophic. Subjective sensations - itching, tightness of the skin.

A benign (youthful) form occurs in early childhood or adolescence and persists throughout life. The clinical picture of skin lesion is similar to that described above.

Black acanthosis can be associated with endocrine disorders (hypothyroidism, insulin-resistant diabetes mellitus, Addison's disease, Cushing's disease).

The paraneoplastic form develops in adults and is characterized by pronounced skin changes with particularly intense gray-black hyperpigmentation, coarsening of the skin relief and severity of papillomatous growths. In the treatment process, the mucous membrane of the gastrointestinal tract and the vagina are involved. There is a lesion of the dorsal surfaces of the hands and feet, but according to the type of acrokeratosis of Gopf.

Skin manifestations in 15-20% of cases for several years precede the clinical manifestations of cancer, in 60-65% they appear simultaneously with the symptoms of cancer and in 20-25% - after the detection of malignant neoplasm.

Pseudoacanthosis develops in obese women against the background of dysfunction of the endocrine system, in particular the ovaries, and also the influence of hot climate. Papillomatous growths are weak or absent.

Diagnostics Papillary-pigmentary dystrophy of the skin (black acanthosis)

Diagnosis of papillary-pigmentary dystrophy of the skin

Differential diagnosis is conducted between individual forms of black acanthosis. The diagnosis is not difficult and is based on a clinical and histological picture.

[19], [20], [21], [22], [23]

Treatment Papillary-pigmentary dystrophy of the skin (black acanthosis)

Treatment of black acanthosis of the skin

Treatment of skin dystrophy papillary-pigment (black acanthosis) is symptomatic. With a benign form prescribe vitamin therapy, restorative means. In severe conditions, aromatic retinoids, cytostatics, etc. Help.

When the paraneoplastic form shows the removal of tumors, after which the recession of the skin process occurs. Outwardly apply 1-2% salicylic ointment and softening creams.