Which dermatologic finding is associated with pediatric obesity?

• A. Acanthosis nigricans
• B. Hypertension
• C. Type 2 diabetes
• D. Obstructive sleep apnea

Answer: (A)

Acanthosis nigricans is a dark, velvety thickening of the skin in body folds such as the back of the neck, armpits, and groin. In children with obesity, this skin change signals insulin resistance, where the body’s cells don’t respond well to insulin and insulin levels rise. The excess insulin can stimulate skin cells and cause the characteristic patches to develop. This finding is particularly important because it can appear before overt type 2 diabetes and underscores the metabolic risks tied to excess weight in kids. The other options—hypertension, type 2 diabetes, and obstructive sleep apnea—are common obesity-related conditions but are not dermatologic findings, so they’re not the skin sign being described here. If you see acanthosis nigricans, it’s a cue to screen for insulin resistance and metabolic risk and to reinforce weight-management efforts.