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Acanthosis nigricans may indicate that the level of blood insulin is elevated, increasing the risk for non-insulin dependent diabetes mellitus (NIDDM). Acanthosis nigricans is the dark thickening of the skin, often on the neck, under the arms, and at the inner elbow. Identification of people at risk for diabetes is important in control of the metabolic disease. Researchers cite studies that show acanthosis nigricans is more common in the obese, particularly among ethnic minority groups. Identification of this skin lesion could be useful in diabetes screening.