It typically occurs in individuals younger than age 40, may be genetically inherited, and is associated with obesity or endocrinopathies, such as hypothyroidism, acromegaly, polycystic ovary disease, insulin-resistant diabetes, or Cushing's disease
You should be screened for diabetes and, although rare, cancer. Controlling blood glucose levels through exercise and diet often improves symptoms.
It is likely to improve in circumstances where a known cause is removed. For example, obesity-related pigmentation will improve with weight loss, and drug-induced is likely to resolve when the drug is ceased. Hereditary variants may or may not fade with age, and malignancy-associated variants may, after a malignancy is removed, fade
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