Vitiligo can mask symptoms of acanthosis nigricans

(HealthDay)—Vitiligo can mask symptoms of acanthosis nigricans (AN), according to a case report published in the November issue of the International Journal of Dermatology.

Alice Garzitto, M.D., from the University of Florence in Italy, and colleagues describe the case of a 60-year-old woman with a previous diagnosis of vitiligo who developed velvety and depigmented cutaneous thickening with hypertrophic depigmented and symmetric verrucose excrescences on the background of depigmented patches in typical areas of vitiligo. She also presented with hyperplastic vegetations of the oral mucosa and tongue, and tripe palms with diffuse velvety thickening and prominent ridges.

According to the report, although the lesions were depigmented and did not exhibit dark coloration, they could be consistent with overlapped AN. Histopathologic findings of the skin lesions were consistent with AN with dermal papillomatosis with a hyperkeratotic but depigmented epidermis. On referral to an oncologist, the patient was found to have a hypodense and irregular neoformation in the left ovary. A poorly differentiated large cell adenocarcinoma was confirmed by biopsy. After tumor excision the AN and vitiligo persisted, suggesting unsuccessful treatment.

"In conclusion, if the patient is affected by concomitant vitiligo, AN could be misdiagnosed due to the atypical clinical presentation of the lesions," the authors write.

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