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November 1987

Acanthosis Nigricans of the Forehead and Fingers Associated With Hyperinsulinemia

Author Affiliations

Dermatology Service Veterans Administration Medical Center Allen Park, MI 48101

Arch Dermatol. 1987;123(11):1441-1442. doi:10.1001/archderm.1987.01660350035013

To the Editor.—  We report a distinctive presentation of typical acanthosis nigricans on the forehead, a conspicuous site that we believe to be clinically important but infrequently recognized and underreported. In this patient, acanthosis nigricans was associated with obesity, hyperinsulinemia, and euglycemia.

Report of a Case.—  A 64-year-old man presented for evaluation with a seven-year history of asymptomatic darkening of the skin on his forehead and neck. The patient was 168 cm (5 ft 6 in) tall and weighed 127.3 kg (280 lb), 197% of ideal body weight. A 22.7-kg (approximately 50 lb) increase in weight had occurred since the 1960s. There was no history of diabetes mellitus, endocrinopathies, malignancy, or atopic skin disease. The patient had a history of tinea pedia for ten years and hypertension.On physical examination, the patient had hyperpigmented velvety plaques located on the back of the neck, axillae, dorsal surface of the proximal interphalangeal

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