I would like to know what else could investigate for this patient

Plz take time and review this case Chief Complaints Hot flush over face 15 day Acanthosis Nigricans over acral and Neck History Patient came to with Complaints of Hot flush over face since 15 days was main complaint....He also showed me his hands fingers and neck region acanthosis nigricans since 2-3 year visited many dermatologist for acanthosis problem...... Vitals All within normal limit Only fasting Suagr was 130mg/Dl Investigations Fasting Insulin Normal, HbA1C 6.9, 2HrPP 230mg/Dl, Thyroid profile WNL, Lipid profile only VLDL moderate raised, Liver function test AST 123 ALT 76 rest Normal, Vit D3 11.38, Vit b12 normal, CBC Normal Diagnosis Recently diagnosed T2DM, Acral Acanthosis Management Tab Ararax 25mg HS Aloe Vera based cream in morning over face Lactocalamine lotion in night over face Tab Glycomet 500SR OD BBF Tab Calcium 500mg BD Sachet Calcitriol 60k iU one weekly Tab Canthax BD Nigrifix cream for locally apply over acral part and neck area Tab Udiliv 300mg BD Tab A to Z OD Tab Veloz D OD BBF Weight Reduction Diabetic diet advise Excersise daily advice Physical Examination BMI 26.4

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thanks for sharing in Ayurveda for Hot flush over face and acanthosis nigricans, Rx Abhyadi qwath BD Galo ghan tab 1bd panxhsakar powder HS for 2 to 3 weeks, then, brihad manjishthadi kashay syurp 20ml bd khadiradi vati 2bd Amyrob tab 2bd Galo ghan tab 1bd locally, on face - Alovera and sandal wood powser+milk+ gulab jal, and for acanthosis nigricans - cutis cream amd aloevera gel. Diet: Khane ke bich me ek ek ghunt pani pina he. yani 1 - 2 nivale ke bad ek ghunt pani. esw pura khana khatam karna he. khana 30% kam lena he.

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Acanthosis nigricans is a fairly common skin pigmentation disorder. The most notable sign of acanthosis nigricans is dark patches of skin with a thick, velvety texture. The affected areas of skin may also itch or have an odor. These patches may appear on skin folds and other areas, such as the: armpits groin neck elbows knees knuckles lips palms soles of the feet Acanthosis nigricans is seen in both men and women. It’s most common in those who are overweight, have darker skin, and have diabetes or prediabetic conditions. who develop acanthosis nigricans are at a higher risk of developing type 2 diabetes later in life. Causes:-Acanthosis nigricans skin patches occur when epidermal skin cells begin to reproduce rapidly. This abnormal skin cell growth is most commonly triggered by high levels of insulin in the blood. In rare cases, the increase in skin cells may be caused by medications, cancer, or other medical conditions. Medications Acanthosis nigricans can also be triggered by certain medications such as birth control pills, human growth hormones, thyroid medications, and even some bodybuilding supplements. All of these medications can cause changes in insulin levels. Medications used to ease the side effects of chemotherapy have also been linked to acanthosis nigricans. In most cases, the condition clears up when the medications are discontinued. skin lighteners, like Retin-A, 20 percent urea, alpha hydroxy acids, and salicylic acid antibacterial soaps oral acne medications laser therapy These treatments can improve the appearance of acanthosis nigricans but will not cure the condition.

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Kindly r/o Neuroendocrine disorder

What what things to look for
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