Acanthosis nigricans is one of the most common skin signs of obesity and hyperinsulinism and is a valuable predictor of insulin resistance in obese children. Patients with both obesity and acanthosis nigricans, compared with those with obesity alone, tend to have higher body mass indexes and increased fasting and evening insulin levels.Early recognition and intervention are crucial to avoid complications of insulin resistance. The general pediatrician is in the best position to perform the...