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(a) Status of axillary acanthosis nigricans prior to starting therapy (b) Status of axillary acanthosis nigricans after the institution of combination therapy with metformin and tapering isotretinoin after 3 months. Considerable improvement can be visualized here. [Figure adapted from Walling HW et al. Improvement of acanthosis nigricans on isotretinoin and metformin. JDD 2003;2:677-81]
