A patient with acanthosis nigricans is likely to have which underlying condition?

Acanthosis nigricans is a skin condition characterized by dark, velvety patches in body folds and creases, commonly seen in areas such as the neck, armpits, and groin. This condition is often associated with insulin resistance and is frequently observed in individuals with obesity and conditions like type 2 diabetes mellitus.

The presence of acanthosis nigricans indicates that there may be hyperinsulinemia, which refers to elevated insulin levels in the blood. This is commonly seen in patients who are obese due to the body's compensatory mechanism to maintain glucose homeostasis. Therefore, the connection between obesity and hyperinsulinemia makes option A the most likely underlying condition associated with acanthosis nigricans.

Conditions such as splenomegaly and pancytopenia, increased Lyme titers, or elevated triglycerides do not have a direct or established relationship with acanthosis nigricans, making them less relevant options in this context. Understanding the link between insulin resistance and acanthosis nigricans is crucial in recognizing the potential metabolic disorders that may be present in affected patients.