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Area of Science:

  • Dermatology
  • Medical Genetics

Background:

  • Acral acanthotic anomaly (AAA), or acral acanthosis nigricans (AAN), is a distinct variant of acanthosis nigricans.
  • Characterized by hyperpigmented, hyperkeratotic plaques on acral surfaces (knuckles, toes, hands, feet).
  • Unlike common forms, AAA is not typically linked to obesity, insulin resistance, or endocrinopathy, with poorly understood pathogenesis.

Purpose of the Study:

  • To synthesize existing literature on AAA.
  • To cover epidemiology, clinical and histopathologic features, and systemic associations.
  • To aid in accurate recognition and clinical evaluation.

Main Methods:

  • A narrative literature review was performed using PubMed.
  • Relevant case reports and reviews were analyzed for data extraction.
  • Focus on presentation, histology, differential diagnosis, and clinical associations.

Main Results:

  • Consistent descriptions of acral distribution and characteristic histologic findings (papillomatosis, hyperkeratosis, basal pigmentation).
  • Often observed in healthy individuals, but potential associations with malignancy or autoimmune disease exist.
  • Data is limited due to rarity, primarily from case reports and small series.

Conclusions:

  • Accurate recognition of AAA is crucial for appropriate clinical management.
  • Helps avoid unnecessary investigations and guides evaluation for potential systemic associations.
  • Highlights the need for vigilance regarding malignancy or autoimmune conditions despite typical benign presentation.