What is the most likely diagnosis?

A 32-year-old obese woman presents to her primary care physician’s offi ce for a
preemployment physical. She states that she is in good health, but she has noticed
darkening areas around her axillae and under her breasts. She fi rst noticed the dark
areas a few years ago but has not paid much attention to them. Her family history is
remarkable for obesity, heart disease, hypertension, and type 2 diabetes mellitus. On
physical examination, the patient is a well-appearing but obese female. Her blood
pressure is 135/85 mm Hg, and her heart rate is 80/min. Her body mass index (BMI)
is 32 kg/m2. Examination of the skin shows prominent skin lines in the patient’s axilla, posterior neck, and underneath her breasts. There are also dark, “dirtyappearing,”
velvety plaques in these regions.

Right Answer Is : Acanthosis Nigricans