The recent dramatic increase in childhood obesity has been accompanied by an increased incidence of acanthosis nigricans (AN), with reports of up to 62% of obese youth having this condition. AN, a dermatologic manifestation characterized by thick and darkened layers of skin, has been proposed as a potentially useful clinical marker of insulin resistance and increased risk of future type 2 diabetes. This contention is supported by metabolic studies, which have shown that in obese children, AN is significantly associated with hyperinsulinemia, impaired postprandial glucose and insulin responses, and type 2 diabetes.
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