**2.4 Skin problems**

Different problems of the integumentary system associated with obesity can be classified on the basis of their pathophysiologic origin (**Figure 4**). Skin lesions associated with mechanical causes include striae, lipodystrophy, plantar hyperkeratosis, and venous insufficiency. Acanthosis nigricans and skin tags or acrochordons are due to insulin resistance. Obesity-related hyperandrogenism may cause acne, hirsutism, and androgenic alopecia. Skin folds created by obesity increase the risk of intertrigo and infections.
