Alshareef Ibrahim, Assiri Sultan, Alosaimi Ashwaq K, Alhothali Omar S, Alsulami Rola R, Alkidaiwi Shahad, Al Hawsawi Khalid
Dermatology, King Saud bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU.
Dermatology, King Abdulaziz Hospital, Makkah, SAU.
Cureus. 2023 Jan 12;15(1):e33706. doi: 10.7759/cureus.33706. eCollection 2023 Jan.
Acanthosis nigricans (AN) is a common chronic disorder that is characterized by velvety-like, hyperpigmented, hyperkeratotic plaques, typically in intertriginous areas. However, atypical presentations have been reported. Here we present a five-year-old boy presented with a one-year history of asymptomatic slowly progressing skin lesions. He is a known case of type 1 diabetes mellites on insulin treatment, otherwise healthy. The review of systems was unremarkable. No similar case was found in the family. Skin examination revealed multiple tiny non-scaly brownish papules on the medial aspects of the upper thighs, bilaterally. Differential diagnosis included skin tags, viral warts, and dermatosis papulose nigra (DPN). Dermoscopic findings revealed a velvety-like appearance on the papules and the normal skin surrounding the papules. A 2-mm punch skin biopsy of the papule revealed papillomatosis of the epidermis, and the granular layer was normal. The dermis was normal. On the basis of the above clinicopathological findings, specifically the velvety texture of the normal skin surrounding the papules, the patient was diagnosed with ANs. The parent was reassured, and we started the patient on daily tretinoin cream.
黑棘皮病（AN）是一种常见的慢性疾病，其特征为出现天鹅绒样、色素沉着、角化过度的斑块，通常位于皮肤褶皱处。然而，非典型表现也有报道。在此，我们报告一名5岁男孩，有1年无症状且缓慢进展的皮肤病变病史。他是1型糖尿病患者，正在接受胰岛素治疗，除此之外身体健康。系统回顾无异常。家族中未发现类似病例。皮肤检查发现双侧大腿内侧有多个微小的无鳞屑褐色丘疹。鉴别诊断包括皮赘、病毒疣和黑丘疹性皮病（DPN）。皮肤镜检查发现丘疹及丘疹周围正常皮肤呈天鹅绒样外观。对丘疹进行2毫米的皮肤打孔活检显示表皮乳头瘤样增生，颗粒层正常。真皮正常。基于上述临床病理表现，特别是丘疹周围正常皮肤的天鹅绒质地，该患者被诊断为黑棘皮病。已向患儿家长解释病情，我们开始让患者每日使用维甲酸乳膏。
