Hyperinsulinemia associated with acanthosis nigricans, finger pebbles, acrochordons, and the sign of Leser-Trelat.

Hyperinsulinemia associated with acanthosis nigricans, finger pebbles, acrochordons, and the sign of Leser-Trelat.

Saraiya Ami; Al-Shoha Ahmad; Brodell Robert T

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

2013

2013-06

OBJECTIVE: To review common skin manifestations associated with type 2 diabetes mellitus (DM), and to discuss a potential underlying mechanism for these manifestations. METHODS: A PubMed literature search was conducted for articles describing the skin manifestations associated with hyperinsulinemia and type 2 DM. A case presentation describes a morbidly obese patient with type 2 DM treated with metformin who developed acanthosis nigricans, finger pebbles, scores of skin tags (acrochordons), and the sign of Leser-Trelat (sudden onset shower of seborrheic keratoses) in the absence of internal malignancy. RESULTS: Acanthosis nigricans, acrochordons, and finger pebbles have been associated with type 2 DM and obesity. While the Leser-Trelat sign is classically associated with internal malignancy, it can also be idiopathic. To our knowledge, this the first report of the occurrence of the Leser-Trelat sign in a patient with DM absent internal malignancy. CONCLUSION: Several skin manifestations can be seen in this patient with DM because of underlying insulin resistance and subsequent stimulation of insulin-like growth factor receptors. Management strategies could include weight loss, diet, and insulin-sensitizing pharmacologic therapy.

Humans; Acanthosis Nigricans/diagnosis/etiology/metabolism; Skin Diseases/diagnosis/*etiology/metabolism; Diabetes Mellitus; Receptors; Somatomedin/metabolism; Type 2/*complications/metabolism

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522–525

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