 This is the snap shot of a 16 year old obese girl, daughter of one of our patients with type 2 diabetes. This blackish velvetty hyper pigmentation at the back of the neck is termed Acanthosis nigricans (AN). It can also appear in the axilla, groin and other body folds and is considered a skin marker for obesity, diabetes, polycystic ovarian disease and thyroid disorders. In clinical practice AN in a 'normal' individual, usually indicates insulin resistance and calls for detailed investigations for endocrine disorders and steps to prevent obesity and diabetes. On evaluation the girl was found to have high lipids and pre diabetes. Presently she is put on strict diet and daily exercise.
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