title: Vulvar acanthosis nigricans: a marker for insulin resistance in hirsute women.
abstract: OBJECTIVE
  To determine the frequency of acanthosis nigricans (AN) in a group of hirsute, hyperandrogenic women and to determine the body site most frequently affected.
  
  
  METHODS
  Cross-sectional observational study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Reproductive age, nonhypertensive, nondiabetic women referred for evaluation of hirsutism, documented to have hyperandrogenism, without medications known to influence lipid, carbohydrate, or hormonal metabolism.
  
  
  METHODS
  None.
  
  
  METHODS
  Presence of AN. Insulin resistance was assessed by measuring fasting glucose, fasting insulin, and nadir glucose after a 0.1 U/kg i.v. insulin bolus in both obese and nonobese, hirsute, hyperandrogenic women.
  
  
  RESULTS
  Twenty-four of 43 women were found to have AN. Although AN was identified at several body sites including the axilla (n = 14), on the nape of the neck (n = 13), below the breasts (n = 7), and on the inner thigh (n = 7), it was always present on the vulva in women who displayed one or more lesions. Acanthosis nigricans was found only in the obese, hirsute, hyperandrogenic women. These women were the most insulin resistant.
  
  
  CONCLUSIONS
  Acanthosis nigricans and insulin resistance are found frequently in obese, hirsute, hyperandrogenic women. The vulva is the most likely place to find this marker.
authors.affiliation: Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City.
authors.forename: C C
authors.initials: CC
authors.lastname: Grasinger
authors.forename: R A
authors.initials: RA
authors.lastname: Wild
authors.forename: I J
authors.initials: IJ
authors.lastname: Parker
mesh_terms: D000052:Acanthosis Nigricans / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D005260:Female; D006628:Hirsutism / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D009765:Obesity / Q000097:blood / Q000503:physiopathology; D014845:Vulvar Diseases / Q000097:blood / Q000150:complications / Q000503:physiopathology*
chemical_list: D001786:Blood Glucose; D007328:Insulin