Clinical Insights into the Pathogenesis and Treatment Strategies of Acanthosis Nigricans: A Bibliometric Study of Current Trends and Future Directions

Background: Acanthosis nigricans (AN) is a recognized cutaneous marker of insulin resistance and metabolic syndrome. Despite its clinical significance and associations with various comorbidities, a comprehensive, quantitative overview of the research landscape is lacking. Objective: This study aimed to conduct a bibliometric analysis to map the global research output, identify key themes and trends, and elucidate the comorbidity network and potential therapeutic strategies for AN. Methods: We performed a bibliometric analysis using publications retrieved from the Web of Science Core Collection (until May 13, 2024). Data from 2098 publications were analyzed using VOSviewer for co-authorship and keyword co-occurrence networks, CiteSpace for temporal trend and burst detection, and the R package bibliometrix for thematic mapping and publication metrics. Results: Analysis revealed that original articles constituted 85.7% of the literature. Research output has accelerated markedly since 2010. Four core research clusters were identified: obesity/metabolic, hormonal, genetic, and malignancy-related. Key comorbidities with strong bibliometric linkages included psoriasis, hidradenitis suppurativa (HS), and acne, centered on shared mechanisms of insulin resistance and inflammation. The analysis highlighted emerging therapeutic directions, particularly the potential of GLP-1 receptor agonists (eg, semaglutide) due to their dual metabolic and anti-inflammatory (eg, TNF-α, IL-17 inhibition) effects, and the complex role of biologics targeting Th1/Th17 pathways. Conclusion: This first bibliometric study of AN delineates its evolving research architecture, confirming its position at the intersection of dermatology, endocrinology, and immunology. The findings underscore shared pathophysiological pathways with several inflammatory skin diseases and point to novel, mechanism-based therapeutic strategies. Future research should prioritize clinical trials to validate these targeted interventions.