Is there a Link Between Dermatosis Papulosa Nigra and Metabolic Syndrome: A Cross-Sectional Exploratory Study

Abstract Background: Dermatosis papulosa nigra (DPN) is a benign, pigmented tumour presenting as tiny papules on the face and neck, mostly in individuals with darker skin types. It is considered a variant of seborrheic keratosis (SK). The metabolic syndrome (MetS), a complex of metabolic abnormalities, is associated with increased risk of cardiovascular disease and diabetes mellitus. There are established cutaneous markers of MetS, such as acanthosis nigricans and skin tags. Furthermore, acanthosis nigricans, skin tags, seborrheic keratosis and dermatosis papulosa nigra (DPN) have been described in diabetics. To our knowledge, there are no studies reported on the association between MetS and seborrheic keratosis/DPN. This study intends to explore the possibility of DPN being a cutaneous marker of MetS. Aims and Objectives: To estimate the prevalence of MetS and its components among patients with dermatosis papulosa nigra and to correlate the prevalence of MetS with the number/severity of DPN. Materials and Methods: A hospital-based cross-sectional study was performed on 100 patients with more than 5 DPNs. Consenting patients were subjected to detailed evaluation, including history, anthropometric measurements and blood investigations, to detect metabolic syndrome. MetS was diagnosed by the presence of three or more of the harmonized criteria given in 2009. Results: The prevalence of MetS in DPN patients was 64%, which is much higher than the prevalence in the general population (30%). The prevalence of MetS was significantly higher in males compared to females (80.6% vs 54.7%, P = 0.01). Among the components of metabolic syndrome, reduced high density cholesterol was the most common positive finding (75%). Conclusion: The prevalence of MetS in DPN patients was much higher compared to the prevalence in the general population, and further studies with a control population are necessary to establish the association between DPN and metabolic syndrome.