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Acanthosis nigricans is asymptomatic or mildly pruritic, but it is troubling to the patient because it suggests the appearance of dirty skin

This can help users who are also on a fitness journey, looking to tone up alongside tanning

Exceptions to typical zonation exist (e.g., inverted type A nevus, with large pigmented epithelioid melanocytes in the mid or deep dermis)

Oral melanocytic pigmentations have been reported in patients with Laugier-Hunziker syndrome (idiopathic lenticular muco-cutaneous pigmentations) and with Carney complex (spotty skin pigmentations, myxomas and endocrine overactivity)

This variant shares clinical and histopathological features with LPP but presents in areas not exposed to sunlight [88]