Role of Metformin in Acanthosis Nigricans

Abstract

The most prevalent dermatologic sign of insulin resistance is acanthosis nigricans (AN), a skin disorder defined by hyperpigmented plagues most often seen in the axilla, groin, and posterior neck. A favorable link exists between fasting insulin levels and the severity of AN. High insulin binding to keratinocyte and fibroblast insulin-like growth factor 1 receptors (IGF-1Rs) is probably the cause of AN. As a result, both cell types proliferate, and plaques and papillomatosis become visible to the naked eye. A rise in circulation free IGF-1 due to elevated insulin levels also promotes keratinocyte proliferation and differentiation. There is currently no cure for AN, although addressing the underlying cause may help affected skin patches return to their usual color and texture. The insulin-sensitizing effect of metformin suggests that it may enhance AN