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Acanthosis Nigricans. Presented by Dr. Francis E. Senear.
J. A., a white girl aged 15, had been in good health except for being obese, weighing 187 pounds (85 Kg.) at the time of presentation. The cutaneous changes were first noticed about three years ago.There are diffuse pigmentation and variable thickening of the skin on the back of the neck (extending inside the hair line), in the axillas, in the sternal region, under the breasts and on the folds of the abdomen, inguinal folds, external genitalia and perineum and folds of the knuckles. Aside from obesity and a mild hypothyroidism there were no pathologic observations on physical examination.Examination of the blood (including chemical examination) and urine showed no abnormalities. The Wassermann reaction of the blood was positive. Roentgenographic studies of the gastrointestinal tract, skull and chest showed no pathologic changes.Histologic examination of tissue from the chest showed the