Velvety pigmentation in her axillae

A 69-year-old woman develops dark, velvety pigmentation in her axillae. She has noticed 10 lb weight loss over the past 3 months with heartburn and early satiety. She notices no other symptoms. Which of the following conditions should she be studied for?

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  1. a visceral carcinoma
  2. lymphoma
  3. diabetes mellitus
  4. sarcoidosis
  5. an allergy

View Explanation

Patients with acanthosis nigricans should be studied for a visceral carcinoma. There are hereditary, drug-induced, and benign forms of acanthosis nigricans as well. Given this patient’s symptoms a gastric malignancy should be ruled out. Diabetics get a benign form of the disorder. Other dermatoses associated with malignancy include dermatomyositis, flushing, acquired ichthyosis, and thrombophlebitis migrans.