Dark neck

If your 7-year-old has dark patches on her neck and underarms but does not have diabetes (as confirmed by a clear HbA1c test), there are several other potential causes to consider:

1. Acanthosis Nigricans (AN): Even without diabetes, AN can appear in areas like the neck and underarms. This condition is often associated with insulin resistance, obesity, or hormonal changes, not necessarily diabetes. It can also be genetic.
2. Obesity or Overweight: Sometimes, being overweight can lead to insulin resistance and the appearance of darker skin, especially in body folds like the neck and underarms.
3. Skin Irritation or Friction: Constant rubbing or irritation from clothing can darken the skin in these areas, especially in children who are active.
4. Hormonal Changes: Even in young children, mild hormonal imbalances can cause skin pigmentation changes. If puberty starts early, this might also contribute.
5. Poor Hygiene or Skin Care: Accumulation of dead skin cells or dirt, combined with sweat, can sometimes darken areas like the neck and underarms. Regular exfoliation and cleansing might help.
6. Genetics: Some children are predisposed to darker skin in certain areas due to genetic factors, which can sometimes be normal.

It would be good to consult a pediatrician or dermatologist to rule out any underlying conditions and get appropriate treatment if needed.

A dark neck and underarms in children, even with normal HbA1c levels, can be due to various factors such as skin friction, genetics, or conditions like acanthosis nigricans. It’s best to consult a pediatrician for a thorough evaluation and guidance.

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