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Posted by Dr. Monica Wonnacott | September 9, 2016

Acanthosis Nigricans: Why Does My Child’s Neck Look Dirty?

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Have you taken a look at the back of your child’s neck recently? If you have noticed that it looks a little like it’s dirty, you’ve got a problem. The medical term for it is acanthosis nigricans. In keeping with my theme of diabetes this week, I decided to address this physical finding that can be seen in type 2 diabetes. While the physical sign doesn’t guarantee your child has type 2 diabetes, it is seen more commonly in type 2 diabetes, obese children, and children with underlying metabolic syndrome.

What is Acanthosis Nigricans?

Acanthosis nigricans is a skin finding (usually associated with an underlying problem). It is characterized by dark patches of skin that are kind of velvety to the touch. It classically happens in the folds of the skin (like arm pits, groin, and the back/base of the neck).

What causes it?

Acanthosis Nigricans is associated with a number of conditions. As previously alluded to, it is associated with insulin resistance. People who become insulin resistant, often ultimately end up with type 2 diabetes.

Acanthosis nigricans is also associated with hormonal disorders (thyroid issues, ovarian cysts, etc.), some drugs (steroids, birth control, etc.), and in rare occasions, cancers. I hesitate to mention cancer, because that’s all a worried parent will read/see, but I feel like I need to be complete. Keep in mind that far and away the most common reason for acanthosis nigricans is that a kid is overweight or obese and the body is starting to have some insulin problems.

How is it diagnosed and treated?

Diagnosis is made visually. There isn’t need for fancy testing to see if it’s acanthosis nigricans. If your pediatrician is worth her salt, she’ll know what it is just by looking at it. The testing that is done is to determine the reason. In terms of treatment, the underlying cause needs to be determined and addressed. So if it is being caused by obesity, your doctor may do blood work on your child to see if he/she has type 2 diabetes. Certainly, your doctor should counsel you and your child on diet and exercise. If the cause is a medication, it may be that changing medications is the treatment of choice. Often once the underlying problem is addressed, the skin discoloration improves.

My kid has it? What should I do now?

If you have done the quick look and low and behold, you’re child has acanthosis nigricans, you should make an appointment to see your doctor. Determining the underlying cause is important. Be prepared, your doctor will likely want to draw blood (the only way to test for type 2 diabetes). Consider that it is a physical manifestation of an underlying problem and get it checked out. Good luck!