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©2013 UpToDate ® Print Email Acanthosis nigricans A velvety, slightly verrucous plaque is present on the neck. Acanthosis nigricans A mildly hyperpigmented, velvety plaque with small papillary projections is present on the neck. Acanthosis nigricans Hyperpigmented velvety plaques are present in the axilla. Reproduced with permission from: www.visualdx.com. Copyright Logical Images, Inc. Acanthosis nigricans Close view of acanthosis nigricans on the posterior neck. Hyperpigmented velvety plaques are present. Reproduced with permission from: www.visualdx.com. Copyright Logical Images, Inc. Acanthosis nigricans A velvety hyperpigmented plaque with associated acrochordae is present in the axilla.