Acanthosis Nigricans and Type II Diabetes in Childhood

ABSTRACT

The authors report two cases of type II diabetes with and without a acanthosis nigricans in children and a case of obese child with acanthosis nigricans encountered at Seoul Eul Ji Hospital in 1994 with review of literatures on relationship of obesity, acanthosis nigricans and type II diabetes. In case 1, 14-year old girl, BMI was 24 (weight, 63.5Kg ; height, 163.0cm). Fasting blood glucose was 253mg/d1 Glycosylated hemoglobin was 11.6% and fasting C-peptide was 3.49ng/m1 and two-hour post-prandial C-peptide was 5.98ng/m1. In case 2, 12-year old boy, BMI was 22 (weight, 62Kg ; height, 167.0cm). The bone age was 15 yrs. He had prominent lesions of acanthosis nigricans in the axillae, elbows, back of neck and umbilicus. Fasting blood glucose was 243mg/d1 and a two-hour post-prandial glucose was 347mg/d1. Glycosylated hemoglobin was 11.2%. Fasting C-peptide was 1.88ng/m1 and a two-hour post-prandial C-peptide was 3.51ng/d1. In case 3, 10-year-old girl, BMI was 25 (weight, 55Kg ; height, 149.0cm). The bone age was 13 years. In the axillae and posterior neck, there were typical hyperpigmented areas of acanthosis nigricans. Random blood glucose was 111.0mg/d1 and glucosuria was absent. In cases 1 and 2, though the doses of insulin were gradually increased in an attempt to lower blood glucose levels, it had no effect on the blood sugar level. however, during the administration of oral hypoglycemic agent, together with encouragement of exercise and restriction of calorie intake, the blood glucose levels were normalized. In case 3, because of her obesity and acanthosis nigricans, she should be placed on appropriate calorie intake and exercise and close observation for onset of diabetes. we experienced two cases of acanthosis nigricans, one case with obesity, another case with obesity and type II DM. So, we report it with a review of literature.