A 5-ft 1-in, 183-lb 14-year-old girl was concerned about the areas of thickened hyperpigmentation on her posterior neck and in her cleavage.
A 5-ft 1-in, 183-lb 14-year-old girl was concerned about the areas of thickened hyperpigmentation on her posterior neck and in her cleavage.
The lesions had a velvety appearance and were asymptomatic. She was not taking any medications. In the past, she had been told to apply a combination of lactic acid and urea to the areas; this treatment resulted in a softening of the affected skin but did not reduce the hyperpigmentation.
Yearly measurements of blood glucose and insulin had been normal. These findings were consistent with a benign acanthosis nigricans.
Acanthosis nigricans, a nonspecific increase in the thickness of the prickle cell layer of the skin, is most commonly associated with obesity. It is also known to develop in persons with diabetes, corticosteroid excess, pineal tumors, endocrine disorders, and genetic variants; nicotinic acid and estrogen may also induce these pigmentary changes. The hyperpigmentation typically involves the axillae; however, it may arise in flexural areas of the neck and groin, the belt line, dorsum of the finger, around the umbilicus and the areola of the breast, and in the mouth.
Most cases of benign acanthosis nigricans are caused by heat and friction in the flexural folds. Losing weight can help reduce skin friction and promote spontaneous resolution of the hyperpigmentation. This patient was advised to lose weight with diet and exercise.
Study suggests rising obesity prevalence may have altered perceptions of healthy body weights
July 7th 2023An analysis of data from nearly 750,000 adolescents from more than 40 countries offers insight into the changing, and possibly inaccurate, perceptions of healthy body weight among younger people since the turn of the century.
AMA asking physicians to de-emphasize BMI use for health and obesity assessment
June 14th 2023The American Medical Association is asking doctors to scale back the use of the body mass index (BMI) when assessing obesity and health in patients, noting it should be used jointly with other measurements, and not solely.