A 39-yearold woman presents with a thickened, hyperpigment velvety lesion over the axillae. This condition is associated with
**Core Concept**
The condition described is a type of skin hyperpigmentation characterized by thickening and velvety texture, typically affecting intertriginous areas such as the axillae. This condition is associated with insulin resistance and is often seen in patients with polycystic ovary syndrome (PCOS).
**Why the Correct Answer is Right**
The condition is likely acanthosis nigricans, a cutaneous manifestation of insulin resistance. Acanthosis nigricans is caused by the accumulation of glycated collagen and elastin in the dermis, leading to hyperpigmentation and thickening of the skin. This condition is often seen in patients with PCOS, type 2 diabetes, or other conditions associated with insulin resistance.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because acanthosis nigricans is not typically associated with eczema or atopic dermatitis.
**Option B:** This option is incorrect because acanthosis nigricans is not typically associated with seborrheic keratoses, which are benign skin growths.
**Option C:** This option is incorrect because acanthosis nigricans is not typically associated with psoriasis, a chronic autoimmune skin condition.
**Clinical Pearl / High-Yield Fact**
Acanthosis nigricans is a marker of insulin resistance and should prompt further evaluation for underlying conditions such as PCOS or type 2 diabetes.
**Correct Answer:** D. Acanthosis nigricans.