ABSTRACT
This chapter presents the case study of a 13-year-old girl. She is complaining of skin changes affecting her neck, which have been progressively worsening over the past 18 months. In particular the changes are leading to name-calling at school with her peers saying her neck is ‘dirty’. Her school attendance for the last term was only 87 per cent. She is a very quiet girl and there is little eye contact through the consultation. Both she and her mother acknowledge that she is overweight. Her menarche was at the age of 11 years and 3 months, her menses are irregular. She is an only child. Her mother has type 2 diabetes, hypertension and is also overweight, her father suffers from asthma. She has mild to moderately severe comedonal acne over face and chest. There are longitudinal striae over her lower abdomen and thighs. There is no evidence of hirsutism.
