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Summary Clinical Presentation Depends on the underlying inflammatory skin disease Usually asymptomatic Histologic Features Melanin pigment and melanophages in the superficial dermis Subjacent mucosal melanophages and fibrosis A sparse perivascular lymphocytic infiltrate may be present Differential Diagnosis Physiologic hyperpigmentation Genital melanosis Vulvar intraepithelial neoplasia, pigmented Takeaway Essentials Clinical Relevant Pearls Same distribution with the underlying inflammatory disease Pathology Interpretation Pearls Increased melanin and melanophages in the papillary dermis Acanthosis Nigricans Clinical Features Acanthosis nigricans is a dermatosis that exhibits a symmetrical pattern of hyperpigmentation with brown, poorly demarcated, thickened velvet-textured plaques with verrucous excrescences [7, 9]

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Unrefrigerated storage accelerates this chemical breakdown, gradually reducing the medication's potency