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Erica A. Mailler-Savage, MD; Brian B. Adams, MD, MPH

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Acanthosis nigricans presents as asymptomatic tan to dark brown velvety plaques usually on the posterior neck and intertriginous areas. It is often a cutaneous manifestation of insulin resistance. Histopathologically, lesions demonstrate hyperkeratosis, papillomatosis, acanthosis, and a thickened dermis. Acanthosis nigricans at the site of repeated insulin injections has been reported at least twice previously in the literature.^1-2 The activation of insulinlike growth factor (IGF) receptors due to high circulating levels of insulin likely causes this lesion.³

Report of a Case

A 63-year-old, 109-kg white man with a 10-year history of insulin-dependent type 2 diabetes mellitus presented with a 1-year history of asymptomatic plaques on both sides of the lower abdomen. The patient reported injecting insulin exclusively into the skin of the 2 affected areas approximately 5 times daily for 10 years. He required large volumes of insulin, including 35 U of insulin aspart before meals . . . [Full Text of this Article]

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