Christopher G. Bunick
Acrochorda (skin tag, fibroepithelial polyp, soft fibroma) are benign pedunculated lesions. They are extremely prevalent, particularly in overweight or obese patients. Acrochorda are more common in women and often develop during pregnancy. Acrochorda are almost always benign, although extremely rarely malignant tumors have been reported to develop within one, which raises controversy in whether to send acrochorda for histopathologic examination after removal. Treatment of acrochorda is straightforward; surgical or scissor removal is quite effective.
Patients present with multiple soft fleshy skin-colored-brown papules that are either pedunculated or more sessile.
Acrochorda (acrochordons, skin tags) are small, ˜0.1 to 1.0 cm, smooth, skin-colored to pink to tan to brown papules commonly located in skin folds, such as the neck, axillae, and groin. Some have a wide base, whereas most are pedunculated in nature. Acrochorda are benign lesions; however, their protruding nature and location in areas of increased friction place them at risk for trauma and irritation. For this reason, an acrochordon can become symptomatic, for example, from rubbing by clothing or trauma by a necklace.
Histologic examination of acrochorda demonstrates pedunculated or papillomatous lesion with fibrovascular stroma.1
Polypoid basal cell carcinoma
The precise pathogenic mechanism of acrochorda is not known, but there is increased incidence among patients who are obese or have diabetes mellitus. Acrochorda have been linked with increased insulin resistance2 and metabolic syndrome.3,4