Dirty Neck- What is it?

[Image- dark neck with thickened, rugose skin]

It is not uncommon to find these dark, dirty appearing rough skin markings on the neck. Many patients also have associated dark skin over the finger joints, elbow, areola, axila. Some even have prominent pigmentation around mouth.
General appearance closely simulates uncleaned skin. Parents who are usually anxious over it start more frequent cleaning with soap etc and vigorous rubbing with scrubbing objects leading to worsening of the skin condition.
This usually starts early in life, mostly during childhood or adolescence. Late onset is also seen but less frequently.
This is medically known as Acanthosis Nigricans.

Commonest reason for this is obesity.
Others causes are hormonal abnormalities. Thus most of the common hormonal diseases like diabetes melitus, polycystic ovarian diseases are ruled out while evaluating this condition.
Late onset with faster progression should arouse suspicion of other internal diseases.


Treatment is dufficult.
Primary focus is always on reducing body weight. Rubbing has to be stopped.
Chemical peel may achieve good response. Hormonal treatment may be necessary if hormonal abnormalities are ditected.

Consultation with a dermatologist is necessary. In selected cases, endocrinologists should also be consulted.

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