Acanthosis nigricans is commonly associated with which condition?

• A. It is a sign of autoimmune disease
• B. It is a sign of liver failure
• C. It is a normal variant of aging
• D. It is commonly associated with insulin resistance

Answer: (D)

Acanthosis nigricans signals insulin resistance. The dark, velvety patches that appear in areas like the neck, axillae, and groin come from the skin’s response to high insulin levels. When the body’s cells don’t respond well to insulin, the pancreas makes more of it (hyperinsulinemia), and this excess insulin can stimulate growth factor receptors in skin cells, causing the thickened, pigmented plaques. That link to insulin resistance places acanthosis nigricans with conditions such as obesity, metabolic syndrome, polycystic ovary syndrome, and type 2 diabetes risk.

It isn’t typically a sign of autoimmune disease, liver failure, or a normal aging variant. Autoimmune conditions and liver failure have other characteristic signs and skin changes, and aging skin doesn’t usually present with this specific velvety hyperpigmentation in flexural areas.