Mohaghegh Fatemeh, Shoushtarizadeh Mohammad, Bahraminejad Masha, Tabatabaei Elham Tavousi, Talebzadeh Zahra
Department of Dermatology and Dermatopathology, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Hezar Jarib Street, Isfahan, 81746-73461, Iran.
J Med Case Rep. 2025 May 25;19(1):252. doi: 10.1186/s13256-025-05315-x.
Acanthosis nigricans is a skin condition characterized by dark, thickened plaques, typically found in intertriginous regions such as the groin and neck. While commonly associated with obesity and insulin resistance, acanthosis nigricans rarely presents on the scalp. This case report highlights an uncommon presentation of acanthosis nigricans.
A 16-year-old Iranian male presented with yellowish-brown, scaly papillomatous plaques on the scalp, along with velvety brown plaques in flexural areas. He had a longstanding history of seborrheic dermatitis on the frontal scalp, which had worsened with weight gain and obesity. Otherwise, the patient was healthy. Histopathological examination revealed papillomatosis, hyperkeratosis, and acanthosis. Despite thorough evaluation for systemic diseases, the diagnosis of acanthosis nigricans was confirmed on the basis of lesions observed on other regions of the body. The patient was treated with keratolytic therapy and advised on weight reduction, leading to significant improvement within 2 months.
While acanthosis nigricans typically manifests in the skin folds, this case highlights the importance of considering acanthosis nigricans as a differential diagnosis in patients with scalp involvement, particularly those with obesity and insulin resistance. Histopathological confirmation remains essential, and management should focus on addressing the underlying etiological factors, as demonstrated by the favorable outcomes achieved through keratolytic therapy and weight management in this patient.
黑棘皮病是一种皮肤疾病，其特征为深色、增厚的斑块，通常出现在腹股沟和颈部等皮肤褶皱部位。虽然黑棘皮病通常与肥胖和胰岛素抵抗有关，但很少出现在头皮上。本病例报告强调了黑棘皮病的一种罕见表现。
一名16岁的伊朗男性患者，头皮上出现黄褐色、鳞屑状乳头瘤样斑块，同时在屈侧部位有天鹅绒样褐色斑块。他有前额头皮脂溢性皮炎的长期病史，随着体重增加和肥胖病情加重。除此之外，患者身体健康。组织病理学检查显示乳头瘤样增生、角化过度和棘层肥厚。尽管对全身性疾病进行了全面评估，但根据身体其他部位观察到的病变，确诊为黑棘皮病。患者接受了角质溶解治疗，并被建议减轻体重，2个月内病情有显著改善。
虽然黑棘皮病通常表现在皮肤褶皱处，但本病例强调了在头皮受累患者中，尤其是肥胖和胰岛素抵抗患者中，将黑棘皮病作为鉴别诊断的重要性。组织病理学确诊仍然至关重要，治疗应侧重于解决潜在的病因，如本患者通过角质溶解治疗和体重管理取得的良好效果所示。
