Acanthosis nigricans
Acanthosis nigricans is a diffuse, velvety, hyperpigmented, "dirty"-appearing skin, mainly in axillae, neck, groin and dorsal hand surfaces. The etiology may be related to factors of heredity, associated endocrine disorders, obesity, and can rarely be a herald of malignancy. Parents should be reassured that acanthosis nigricans is unrelated to hygiene.