This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Immune system, Subject name: Medicine
A 39-yearold woman presents with a thickened, hyperpigment velvety lesion over the axillae. This condition is associated with 
Select and explain. 
A. Frequent wearing of velvet clothes, B. SLE, C. Tuberculosis, D. Insulin resistance
D: Insulin resistance
Answer: D: Insulin resistance 
Explanation: skin tags may indicate insulin resistance. .Acanthosis nigricans manifests as areas of dark, velvety discoloration in body creases and folds such as the armpits, groin, and neck, sometimes causing skin to become thickened Ref Davidson 23rd edition pg 719