June 12, 2000
Diagnosis and Symptoms
Question from Minneapolis, Minnesota, USA:
I have a 9 year old son who is about 20 pounds overweight. He was diagnosed with hyperinsulinaemia last year. We have had him on a diet that limits his sugar intake and is very healthy (no junk food). He is still gaining weight and the dark line around the back of his neck and dark pigmentation under his arms (which the doctor said was one indicator of this problem) is getting more pronounced. I am having a hard time finding any information on this and am not sure how to handle it. Any advice you could give would be greatly appreciated.
Answer:
The finding of dark color on the skin of the neck in your son is a cutaneous manifestation (i.e. a dermatological disorder called acanthosis nigricans) of the syndrome of insulin resistance with marked resistance to endogenous insulin. Such a high levels of insulin activates the EGF (Epidermal Growth Factor) receptor on the skin (spillover effect) with the consequent thickening of the skin and appearance of a variety of brown, velvety hyperkeratotic patches in the body folds.
MS
