Association of acanthosis nigricans with metabolic syndrome - An analytic cross-sectional study

Abstract Background: Globally, few studies have been undertaken to assess the association of acanthosis nigricans (AN) with metabolic syndrome (MS). Most of the available studies have either focused on a particular age group, gender, ethnicity or on a single component of MS. Objectives: To determine the association between AN and MS as a whole and with all individual components of MS in adult patients of either gender. Material and methods: This was a cross-sectional study with a comparative group. Eighty-one subjects were recruited in each group. Fasting plasma glucose (FPG) and lipid profile were done. MS was defined by using the international diabetic federation (IDF) criteria. Association of body mass index (BMI), waist circumference, blood pressure, FPG, high-density lipoprotein (HDL) and triglycerides (TG) with AN was assessed by Pearson's chi-square test followed by univariate and multivariate analysis. Results: The prevalence of MS was found to be significantly higher in the group with AN. On univariate analysis, a significant association of AN was found with BMI, waist circumference, high systolic and diastolic blood pressure, HDL, and TG. Multivariate analysis revealed a significant association between waist circumference, high systolic and diastolic blood pressure, and high TG levels with AN. The risk of MS was found to be eight times higher in cases of AN. Study limitations: The small sample size and single-center data are the limitations of the present study. Conclusion: AN is strongly associated with MS as a whole and with its individual components including increased waist circumference, hypertension, and dyslipidemia.

Dermatitis artefacta: Keloids and foreign body granuloma due to overvalued ideation of acupuncture.

Skin is well recognized as an important somatic mirror of one's emotion and a site for the discharge of one's anxieties. We present a case of a 42-year-old female patient presenting with a vague history of generalized body pain and skin lesions in the form of cotton threads buried under the skin, crusted plaque, multiple keloids and rusted pin buried through the skin mostly in the easily accessible areas of the body. Histopathology from the crusted plaque revealed foreign body granuloma. To satisfy her psychological or emotional need, it is the deliberate and conscious production of self-inflicted skin lesions through overvalued ideation of acupuncture on her part.