Skin Tag

Aka: Skin Tag, Acrochordon, Fibroepithelial Stromal Polyp, Fibroepithelial Polyp

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II. Definitions

  1. Skin Tag (Acrochordon, Fibroepithelial Stromal Polyp)
    1. Benign epidermal hyperplastic lesion (Skin Tag)

III. Epidemiology

  1. Very common (occurs in 25% of adults)
  2. Increasing Prevalence with age (esp. age 20 to 50 years)

IV. Risk factors

  1. Obesity
  2. Advancing age
  3. Pregnancy
  4. Metabolic Syndrome or Diabetes Mellitus

V. Pathophysiology

  1. Develops in regions of increased skin friction and irritation
  2. Lesion of mesenchymal origin
  3. Hormone Sensitive

VI. Signs

  1. Characteristics
    1. Usually pedunculated (narrow stalk) but may be sessile
    2. Flesh-colored to brown
    3. Typically 2-5 mm in size (may be up to 1 cm, up to 20 cm in rare cases)
    4. May ulcerate or erode, bleed or have discharge with irritation
  2. Distribution (areas of friction)
    1. Axilla
    2. Neck
    3. Inguinal area
    4. Vulva

VII. Differential Diagnosis

  1. Pedunculated intradermal nevus
  2. Seborrheic Keratosis
  3. Neurofibroma
  4. Nevoid Basal Cell Carcinoma syndrome
    1. Skin Tags seen in childhood
    2. Only indication to send Skin Tags for histology
    3. Chiritescu (2001) J Am Acad Dermatol 44:789-94 [PubMed]

VIII. Labs

  1. Pathology is indicated in only atypical lesions
    1. Send one specimen per jar

IX. Management

  1. Indications for excision
    1. Local irritation (often caught on jewelry or clothing)
    2. Cosmesis
    3. Biopsy if present in childhood (see above)
  2. Techniques for destruction
    1. Refer those with Eyelid involvement
    2. Local Anesthesia only required for larger lesions
      1. Cut quickly in one stroke if not using Local Anesthesia
    3. Pedunculated Skin Tags
      1. Excise with iris scissors
        1. Pre-apply Topical Antiseptic (e.g. Alcohol, Chlorhexidine, Povidone Iodine)
        2. Apply topical Aluminum Chloride (e.g. Drysol) for coagulation
      2. Electrodesiccation
        1. Electrocautery at lesion base
        2. Preferred over cautery in darker skinned patients
      3. Cryotherapy with Liquid Nitrogen (for small Skin Tags)
        1. Exercise caution in patients with darker skin (risk of Hypopigmentation)
        2. Consider using an ear speculum to focus Cryotherapy on lesion
    4. Sessile Skin Tags
      1. Shave excision

X. References

  1. Tavelli in Noble (2001) Primary Care, Mosby, p. 771
  2. Higgins (2015) Am Fam Physician 92(7): 601-7 [PubMed]
  3. Luba (2003) Am Fam Physician 67(4):729-738 [PubMed]
  4. Oluyadi (2023) Am Fam Physician 107(1): 87-8 [PubMed]
  5. Wagner (2024) Am Fam Physician 110(4): 353-61 [PubMed]

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Related Studies

Ontology: Skin tag (C0037293)

Definition (CHV) benign skin tumor
Definition (CHV) benign skin tumor
Definition (CHV) benign skin tumor
Definition (CHV) benign skin tumor
Definition (CHV) benign skin tumor
Definition (CHV) benign skin tumor
Definition (CHV) benign skin tumor
Definition (CHV) benign skin tumor
Definition (CHV) benign skin tumor
Definition (CHV) benign skin tumor
Definition (CHV) benign skin tumor
Definition (NCI) A polypoid lesion composed of fibrous tissue and epithelium. Representative examples include skin tag, anal fibroepithelial polyp, and gingival fibroepithelial polyp.
Definition (NCI_CDISC) A benign polypoid tumor comprising fibrous tissue and epithelium.
Definition (NCI) A small, benign growth that arises from the skin. It is characterized by the presence of fibrovascular tissue lined by epidermis. It may be sessile or pendulous and usually occurs in sites where there is friction.
Concepts Neoplastic Process (T191)
SnomedCT 255183007, 156440000, 201091002, 31069005, 80801001, 2710003, 189051001
English Skin tag, Skin tag NOS, cutaneous tag, acrochordon (diagnosis), acrochordon, skin tag (physical finding), skin tag, Skin tags, Soft Fibroma, Fibroma Molle, skin polyps, fibroma molle, Polyp(s);skin, acrochordons, fibroepithelial polyp, cutaneous tags, fibroepithelial polyps, achrochordon, Acrochordons (skin tag), Skin tag NOS (disorder), FIBROPAPILLOMA, BENIGN, Fibroma molle, Fibroepithelial papilloma, Achrochordon, Acrochordon, Cutaneous polyp, Cutaneous tag, Fibroepithelial polyp, SKT - Skin tag, Soft fibroma, Soft papilloma, Tag, Fibroepithelial polyp (morphologic abnormality), Skin tag (disorder), Tag (morphologic abnormality), tag; skin, Tag, NOS, Cutaneous Fibroepithelial Polyp, Cutaneous Tag, Fibroepithelial Polyp of Skin, Fibroepithelial Polyp of the Skin, Fibroepithelial Polyp, Skin Tag, skin polyp, skin tags
Italian Acrochordon, Pliche della cute, Fibroma molle
Dutch fibroma molle, huidrafels, aanhangsel; huid, acrochordon
German Fibroma molle, Akrochordone, Akrochordon
Portuguese Molusco pêndulo, Fibroma molle, Acrocordão
Spanish Papiloma cutáneo, Fibroma péndulo, acrocordón, SAI, acrocordón, SAI (trastorno), papiloma cutáneo, SAI, acrocordón (anomalía morfológica), acrocordón, apéndice cutáneo, fibroma blando (trastorno), fibroma blando, papiloma blando, papiloma cutáneo (anomalía morfológica), papiloma cutáneo, papiloma fibroepitelial, pólipo fibroepitelial (anomalía morfológica), pólipo fibroepitelial, Acrocordon
Japanese アクロコルドン, 軟性線維腫, ﾅﾝｾｲｾﾝｲｼｭ, ｱｸﾛｺﾙﾄﾞﾝ
Czech Akrochordon, Měkký fibrom, Fibroma pendulans
Hungarian Bőrredők, Fibroma molle, Acrochordon
French Molluscum pendulum, Fibrome mou, Acrochordon
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Hyperplastic Skin Disorders

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