DS: Screening for type 2 diabetes in children with acanthosis nigricans. Diabetes Educ 2006

Acanthosis nigricans is a physical finding of the skin that appears to be a marker for insulin resistance. Because of the association of insulin resistance and type 2 diabetes, acanthosis nigricans may also be a marker for type 2 dia-betes. Some states have recommended statewide screen-ing for acanthosis nigricans. However, this has led to a large referral of children to pediatric endocrinologists. Presented is a schema for primary care physicians and school nurses to use as a guideline for referral of children with acanthosis nigricans. Acanthosis nigricans (AN) was described in1889 by a German dermatologist.1 It is aphysical finding of the skin that appears tobe a maker for high insulin levels and isthus suggestive of insulin resistance.2-4 In people with AN, the skin is thicker, darker, and rougher, particularly in skin creases. The findings are most com-monly found on the posterior neck and axilla. Other com