High levels of insulin stimulate epidermal keratocytes and dermal fibroblasts via insulin-like growth factor receptors (IGF-1). The keratocyte proliferation leads to skin changes like papillomatosis and hyperkeratosis (4).
Encourage diet and exercise to all age groups to reduce likelihood of insulin resistance syndrome.
Medications are not generally indicated; however, metformin has the most promising data to support its use in reducing AN lesions. Also added benefits include improvement in insulin levels and weight loss with minimal adverse reactions.
Refer to dermatologist if diagnosis of AN is not definite.
Maintain a well-balanced, low-calorie diet to achieve weight loss, if applicable.
Related to underlying cause of AN
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