Acanthosis nigricans with involvement of the esophagus and vitamin a deficiency
Krebs, A.
Schweizerische Medizinische Wochenschrift 92: 545-552
1962
ISSN/ISBN: 0036-7672 PMID: 14459491 Document Number: 8184
After a brief clinical description of acanthosis nigricans, the case of a 68-year-old woman with malignant, acanthosis nigricans is presented in full. Of special interest in this case were marked reduction of the vitamin A level in the blood (50 I.U./100 ml) and a defect in dark adaptation. Autopsy revealed the rare picture of acanthosis nigricans of the oesophageal mucosa. The wall of the small intestine showed multiple metastases of gastric carcinoma (solid and cylindrical cell carcinoma). The liver was free of metastases. It is suggested that the vitamin A deficiency may have resulted from faulty absorption due to multiple metastases of the small intestine. There follows a discussion of acanthosis nigricans, its clinical significance, sub-groups, etiology, therapy and differential diagnosis. Special attention is given to distinguishing between benign and malignant forms of the disease and the relationship of acanthosis nigricans to vitamin A metabolism. Vitamin A deficiency causes hyperpigmentation of the skin, abnormal cornification and general dryness, i.e., lesions which to some extent are found in acanthosis nigricans. In this disease the skin condition can often be improved by long-term treatment with large doses of vitamin A.
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