Abstract

Acanthosis nigricans (AN) presents as thickened, velvety or verrucous hyperpigmentation in skin folds, especially the neck and axilla. It is most commonly associated with endocrine disorders, obesity, and insulin resistance. However, AN that has sudden onset and is widespread should raise concern for malignancy. We present two cases to highlight the appearance of AN as a paraneoplastic syndrome. In cases of atypical AN, the importance of a more thorough malignancy work-up, apart from age related cancer screening, cannot be understated. This work-up may include CT chest abdomen pelvis or PET scan.