When my 11 year old daughter was at the doctor’s for a typical vaccination visit, she noticed the dark skin on my daughter’s neck and under her arms which she did not think that this was simple a build up of dry skin. She asked about a family history of diabetes (which we have) and, after also noting that my daughter is overweight, the doctor now wants to test her for diabetes. The doctor said the skin was soft and “velvety” which is why it concerned her. I had never heard of this kind of skin condition. I thought the skin problem was due to my daughter’s darker skin, and the doctor said the skin was soft and “velvety” which is why it concerned her. Can you shed any light on this? My daughter does not seem to be having any symptoms of diabetes.

If you search our database of questions, you will find that many others have had similar questions to yours.

What you are describing is called Acanthosis Nigricans. It is a darkening and thickening of the skin that often occurs around the neck (more often the back of the neck), underarms, and sometimes elsewhere. Textbooks describe this as sometimes being so thick as to be “velvety”, although I have only seen it that thick on just one to two dozen occasions. It commonly occurs in people who make excess insulin. Why do they make extra insulin? Because their bodies are bit insulin resistant, they must make more insulin to get the same effect. This often occurs in heavyset folks and often is the forerunner to developing type�2 diabetes. It is seen more often in African-Americans, Hispanics, and Pacific rim peoples.

There are some medical therapies to consider to improve the insulin excess, some of which are similar to treatments of folks who indeed have type 2 diabetes, but the key is weight loss. Things you can do to get the ball rolling is to have her decrease her intake of sweets and carbohydrates. Switch to sugar-free soda and Kool-Aid. Limit the amount of juice she drinks. Crystal Lite is okay. Talk with a dietitian.

Will your daughter develop diabetes? Maybe, but it is a highway that she can get off.

DS

[Editor’s comment: See What You Need to Know about Type 2 Diabetes in Children.

SS]