The skin manifestations that you would find…
underneath the armpit here, we have darkening.
This is called thickening of your keratinocytes
which then appears dark.
That is the dissection of the term that I’ve
given you called Acanthosis nigricans.
Usually, this is due to, well, research is
showing us that evidence that insulin early
on in type II diabetic may actually result
in such manifestations, maybe the back of
the neck as well and the inguinal region.
Associated with insulin resistance, sometimes
seen with underlying malignancy even perhaps
Another skin manifestation that you would
expect to find is called necrobiosis lipoidica
and what this means is that around the area
of the skin where it’s being damaged because
of lack of blood supply and such, that you
would find oval, irregular, indurated with
central atrophy and yellow pigmentation referring
to your lipid that you might find with red-brown
There is necrosis that’s taking place locally
with deposition of lipid known as necrobiosis
Uncommon but could be seen with patients with
pre-diabetes or diabetes.
Obviously, this has nothing to do with acanthosis
Often asymptomatic, usually that’s found
on the shin.
The way that you would treat this is not very
effective, but you still would have to give
For ulcers, you’re worried about, once again,
the development of gangrene and perhaps the
risk of amputation therefore cyclosporine,
oxygen and maybe anti-TNF therapy with infliximab,
steroids and other therapies.
There’s a wide list here, at least be able
to, at this point, identify necrobiosis lipoidica
that-that could be a rare complication, but
still quite relevant to any case that you
are going to be looking at.