Abstract：
BACKGROUND: Acanthosis nigricans (AN) is a visible cutaneous manifestation of several underlying systemic conditions, such as prediabetes, diabetes mellitus (DM), polycystic ovarian syndrome (PCOS), metabolic syndrome (MS), and malignancy. AN is commonly seen in obese individuals and is a proven skin marker of insulin resistance (IR). Its typical clinical presentation and location, especially on the nape of the neck, allows for easy visual identification. Obesity, IR, and other noncommunicable diseases (NCD) are on the rise in India, with many cases being undiagnosed or missed. Every sixth diabetic in the world is Indian. AN can thus play a vital role in screening, early identification, and reduction of morbidity, especially of IR-related disorders. Currently, there are no national or international multidisciplinary guidelines or recommendations for AN.
OBJECTIVE: To review published current literature and evidence on AN, its associations, and management. To recommend an approach to clinical identification of AN, associated/underlying disorders, investigations, and management, including lifestyle modifications. To sensitize and familiarize clinicians and healthcare workers across India with AN presentations. This will enable early detection of conditions such as IR, prediabetes, DM, PCOS, malignancy, etc., in practice and in the community.
METHODS: The PCOS Society of India constituted a multispecialty Expert Working Group with representation from various national societies to review all published scientific evidence. Expert group meetings were conducted to provide recommendations.
CONCLUSIONS: Acanthosis nigricans is a simple, non-invasive, cost-effective screening tool for early identification of IR. It is important to integrate and disseminate information and training on AN across medical specialties. The government of India has launched several National Health Programmes to help address the rising burden of NCD in the population. AN would provide a simple screening tool to pick up undiagnosed or missed cases.
OBJECTIVE: To review published current literature and evidence on AN, its associations, and management. To recommend an approach to clinical identification of AN, associated/underlying disorders, investigations, and management, including lifestyle modifications. To sensitize and familiarize clinicians and healthcare workers across India with AN presentations. This will enable early detection of conditions such as IR, prediabetes, DM, PCOS, malignancy, etc., in practice and in the community.
METHODS: The PCOS Society of India constituted a multispecialty Expert Working Group with representation from various national societies to review all published scientific evidence. Expert group meetings were conducted to provide recommendations.
CONCLUSIONS: Acanthosis nigricans is a simple, non-invasive, cost-effective screening tool for early identification of IR. It is important to integrate and disseminate information and training on AN across medical specialties. The government of India has launched several National Health Programmes to help address the rising burden of NCD in the population. AN would provide a simple screening tool to pick up undiagnosed or missed cases.
摘要：
背景：黑棘皮病（AN）是几种潜在全身性疾病的可见皮肤表现，比如糖尿病前期，糖尿病（DM），多囊卵巢综合征(PCOS),代谢综合征（MS），和恶性肿瘤。AN常见于肥胖个体,并且是胰岛素抵抗(IR)的经证实的皮肤标志物。其典型的临床表现和部位,尤其是在脖子上,允许容易的视觉识别。肥胖,IR,其他非传染性疾病（NCD）在印度呈上升趋势，许多病例未被诊断或漏诊。世界上第六个糖尿病患者是印度人。因此，AN可以在筛查中发挥至关重要的作用，早期识别,降低发病率，尤其是与IR相关的疾病。目前,没有国家或国际多学科指南或建议。
目的：回顾已发表的关于AN的现有文献和证据，其协会,和管理。为了推荐一种临床鉴定AN的方法，相关/潜在的疾病，调查,和管理,包括生活方式的改变。让印度各地的临床医生和医护人员了解和熟悉AN演示文稿。这将使早期检测条件，如红外，前驱糖尿病，DM,PCOS,恶性肿瘤，等。,在实践中和社区中。
方法：印度PCOS协会成立了一个多专业专家工作组，由各个国家协会代表审查所有已发表的科学证据。举行了专家组会议以提供建议。
结论：黑棘皮病是一种简单的，非侵入性，用于早期识别IR的具有成本效益的筛选工具。重要的是要整合和传播有关医学专业的信息和培训。印度政府已经启动了几项国家卫生计划，以帮助解决非传染性疾病在人口中不断增加的负担。AN将提供一种简单的筛查工具来收集未诊断或漏诊的病例。
目的：回顾已发表的关于AN的现有文献和证据，其协会,和管理。为了推荐一种临床鉴定AN的方法，相关/潜在的疾病，调查,和管理,包括生活方式的改变。让印度各地的临床医生和医护人员了解和熟悉AN演示文稿。这将使早期检测条件，如红外，前驱糖尿病，DM,PCOS,恶性肿瘤，等。,在实践中和社区中。
方法：印度PCOS协会成立了一个多专业专家工作组，由各个国家协会代表审查所有已发表的科学证据。举行了专家组会议以提供建议。
结论：黑棘皮病是一种简单的，非侵入性，用于早期识别IR的具有成本效益的筛选工具。重要的是要整合和传播有关医学专业的信息和培训。印度政府已经启动了几项国家卫生计划，以帮助解决非传染性疾病在人口中不断增加的负担。AN将提供一种简单的筛查工具来收集未诊断或漏诊的病例。
