Comparative Study between Topical Metformin 30% cream and Topical Adapalene 0.1 % cream in the Treatment of Acanthosis Nigricans (Clinicodermoscopic study)

Abstract Background: Acanthosis nigricans (AN) is a skin disorder with high prevalence. Dermatologists usually prescribe topical keratolytic, laser approaches, or chemical peels for aesthetic reasons. Adapalene is a topical retinoid with high degree of success in treating AN. Metformin is an insulin sensitizer that was suggested as a treatment modality for AN by targeting the insulin resistance associated with AN. Aim of the work: Compare the safety and effectiveness of topical 30% metformin cream versus topical adapalene 0.1 cream) in treatment of AN. Patients and methods: The current included 40cases with AN. Cases were randomly distributed into two groups (Each of 20 patients), Results: Between the examined groups, there is a statistically substantial variation with relation to improvement degree for all dermoscopic findings assessed after treatment. The degree of dermoscopic improvement was better in the adapalene group. Also, the degree of clinical improvement was better in the adapalene group. The mean ANASI score changed from 32.4 to 27.8 pre and post-operative for metformin group and from 26.8 to 18.4 for adapalene group. Percent of change is higher among adapalene group without a statistically significant difference between them. Conclusion: adapalene 0.1% cream was more effective for treating acanthosis nigricans than Metformin 30% cream, but it caused more local complications. Regarding the likelihood of recurrence, no variation between the two therapeutic regimens was found.