Syndrome of insulin resistance with acanthosis nigricans, acral hypertrophy and muscle cramps in an adolescent - a rare diagnosis revisited.

The authors report a 14-y-old boy with insulin resistance, acanthosis nigricans, acral hypertrophy and muscle cramps. While there was a dramatic response of the muscle cramps to phenytoin therapy, some other features of metabolic syndrome did not respond to phenytoin therapy alone.