CUTANEOUS MANIFESTATIONS ASSOCIATED WITH PEDIATRIC OBESITY AND METABOLIC DYSFUNCTION: A SCOPING REVIEW AND EVIDENCE MAP
Palabras clave:
Obesidad pediátrica; acantosis nigricans; resistencia a la insulina; síndrome metabólico; manifestaciones cutáneas; hidradenitis supurativa; acrocordones; revisión exploratoriaResumen
DOI: https://doi.org/10.46296/yc.v10i19.1016
Resumen
Los hallazgos cutáneos visibles pueden indicar disfunción metabólica relacionada con la obesidad en niños, pero su asociación con la adiposidad a menudo se confunde con el valor diagnóstico o predictivo. Esta revisión exploratoria rápida y mapa de evidencia examinó los vínculos entre las manifestaciones cutáneas, la obesidad pediátrica y las anomalías cardiometabólicas. Se utilizaron MEDLINE/PubMed, PubMed Central, sitios web de editores, contenido indexado en SciELO y búsqueda de citas hasta el 25 de julio de 2026. La evidencia se clasificó desde la asociación con la obesidad (Nivel 1) hasta la predicción metabólica longitudinal (Nivel 5). Se mapearon veinticinco estudios primarios publicados entre 2008 y 2025, incluido un estudio de edad mixta retenido como evidencia contextual cuyas estimaciones agregadas no se trataron como específicas para la población pediátrica. La acantosis nigricans tuvo la evidencia más desarrollada, con asociaciones que involucran adiposidad, resistencia a la insulina, presión arterial, disglucemia, anomalías lipídicas y, en algunas cohortes, esteatosis hepática. El rendimiento diagnóstico varió; Un estudio pediátrico reportó una sensibilidad del 73,5% y una especificidad del 50,0% para la resistencia a la insulina. El análisis de mediación sugirió que el índice de masa corporal explicaba gran parte de la asociación en niños mexicoamericanos. Otros hallazgos, incluyendo acrocordones, estrías distensas, queratosis pilaris, acné, hiperhidrosis, intertrigo, infecciones, hiperqueratosis plantar e hidradenitis supurativa, se asociaron con la obesidad, pero su valor metabólico independiente seguía siendo incierto. Las cohortes longitudinales vincularon la adiposidad con la hidradenitis supurativa y las dermatosis inmunomediadas posteriores; no establecieron estas afecciones como predictores de futuras enfermedades metabólicas. La acantosis nigricans puede respaldar la evaluación del riesgo clínico, pero no puede reemplazar la evaluación metabólica basada en guías. Ninguno de los estudios mapeados proporcionó evidencia convincente de que un hallazgo cutáneo prediga de forma independiente futuras enfermedades metabólicas pediátricas después de tener en cuenta la adiposidad. Se necesitan definiciones estandarizadas, análisis ajustados, estudios de rendimiento diagnóstico y cohortes prospectivas.
Palabras claves: Obesidad pediátrica; acantosis nigricans; resistencia a la insulina; síndrome metabólico; manifestaciones cutáneas; hidradenitis supurativa; acrocordones; revisión exploratoria.
Abstract
Visible skin findings may signal obesity-related metabolic dysfunction in children, but their association with adiposity is often conflated with diagnostic or predictive value. This rapid scoping review and evidence map examined links between cutaneous manifestations, pediatric obesity, and cardiometabolic abnormalities. MEDLINE/PubMed, PubMed Central, publisher websites, SciELO-indexed content, and citation searching were used through July 25, 2026. Evidence was classified from association with obesity (Level 1) to longitudinal metabolic prediction (Level 5). Twenty-five primary studies published from 2008 to 2025 were mapped, including one mixed-age study retained as contextual evidence whose aggregate estimates were not treated as pediatric-specific. Acanthosis nigricans had the most developed evidence, with associations involving adiposity, insulin resistance, blood pressure, dysglycemia, lipid abnormalities, and, in some cohorts, hepatic steatosis. Diagnostic performance varied; one pediatric study reported 73.5% sensitivity and 50.0% specificity for insulin resistance. Mediation analysis suggested that body mass index explained much of the association in Mexican American children. Other findings, including acrochordons, striae distensae, keratosis pilaris, acne, hyperhidrosis, intertrigo, infections, plantar hyperkeratosis, and hidradenitis suppurativa, were associated with obesity, but their independent metabolic value remained uncertain. Longitudinal cohorts linked adiposity with subsequent hidradenitis suppurativa and immune-mediated dermatoses; they did not establish these conditions as predictors of future metabolic disease. Acanthosis nigricans can support clinical risk assessment but cannot replace guideline-based metabolic evaluation. None of the mapped studies provided convincing evidence that a cutaneous finding independently predicts future pediatric metabolic disease after accounting for adiposity. Standardized definitions, adjusted analyses, diagnostic-performance studies, and prospective cohorts are needed.
Keywords: Pediatric obesity; acanthosis nigricans; insulin resistance; metabolic syndrome; skin manifestations; hidradenitis suppurativa; acrochordons; scoping review.
Información del manuscrito:
Fecha de recepción: 14 de julio de 2026.
Fecha de aceptación: 10 de septiembre de 2026.
Fecha de publicación: 28 de octubre de 2026.
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