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Health Protocols

Skin Disorders

Assessing Skin Problems

The skin is exposed to many irritants—external and internal—and is very physiologically active; thus, it can be affected by a wide array of disorders. A thorough medical history and physical exam are essential to ensure accurate diagnosis (Rajan 2012). The diagnostic exam takes into account the location of the lesion within the layers of skin, pattern of distribution of lesions on the body, and physical characteristics of the lesions. Microscopic exam, culture, and biopsy can be helpful in confirming an uncertain diagnosis. In some cases, blood and urine tests are used to investigate possible underlying systemic disease. Skin prick and patch tests may be used to identify allergens (Marks 2013; Ashton 2014).

Skin Manifestations of Insulin Resistance

Insulin plays an important role in skin health, regulating the growth and development of keratin-producing cells that support structural integrity. Insulin resistance can disrupt normal skin cell function (Napolitano 2015; Boehncke 2012), and has been associated with several skin disorders:

  • Acanthosis nigricans, a chronic skin condition characterized by patches of thick, darkened skin, is among the most common skin manifestations of insulin resistance (Napolitano 2015). Metformin, a first-line diabetes medication, has been shown to benefit patients with acanthosis nigricans. In one intriguing case of an adolescent with insulin resistance and extensive acanthosis nigricans, two years of metformin therapy resulted in complete remission of the acanthosis nigricans (Giri 2017).
  • Acne has been increasingly linked with metabolic disturbances involving insulin resistance (Kumari 2013; Del Prete 2012).
  • Psoriasis appears to be closely linked to insulin resistance (Napolitano 2015).
  • Skin tags are common in obese individuals and may be associated with insulin resistance (Napolitano 2015; Barbato 2012).

More information about insulin resistance and maintaining healthy blood glucose metabolism is available in the Diabetes and Glucose Control protocol.