Which malignancy is most commonly associated with acanthosis nigricans?

Acanthosis nigricans is a skin condition characterized by dark, velvety patches in body folds and creases. It is often associated with insulin resistance and can occur in a variety of conditions, including obesity and diabetes. However, in the context of malignancy, the most significant association is with gastric carcinoma, particularly the type associated with underlying syndromes such as malignant neoplasms.

Gastric carcinoma can lead to the paraneoplastic syndrome of acanthosis nigricans due to the production of certain growth factors or insulin-like substances by the tumor. This association highlights a potential malignancy in patients presenting with unexplained acanthosis nigricans, prompting further investigation for underlying gastric pathology.

While ovarian carcinoma, malignant melanoma, and multiple myeloma can be associated with various skin changes, they do not have the strong correlation with acanthosis nigricans as seen with gastric carcinoma. Recognizing this link can be crucial for early diagnosis and management of potentially underlying malignancies.