Sad but true...Texas state law requires us to screen 7th, 5th, 3rd, and 1st graders for Acanthosis Nigricans. We used to only screen 7th graders, then it went to 5th, then 3rd, and a few years ago 1st grade was added. The numbers go up every year in spite of the state screening mandate and in spite of all the nutrition/exercise information that abounds.
I have yet to run into an ex-student around town that I identified, and referred, with Acanthosis as a youngster that doesn't look like an older/larger version of the kid I remember...but with greater and more marked Acanthosis.