DERMATOLOGY FOR THE USMLE BENIGN SKIN DISORDERS (4) 4. ACROCHORDON

DERMATOLOGY FOR THE USMLE

BENIGN SKIN DISORDERS (4)

4. ACROCHORDON

→	General: Also known as skin tag or fibroepithelial polyp. Benign skin growth with no malignant potential; common in elderly patients. Acrochordons are associated with insulin resistance: √ Diabetes mellitus (DM) and metabolic syndrome √ Polycystic ovarian syndrome (PCOS) √ Pregnancy (due to human placental lactogen)
→	Clinical: Characterized by a pedunculated, tan-to-brown soft tag of skin attached to the body by a stalk. Mainly located in areas of friction such as the axillae, groin, neck and eyelids. Skin tags may be single or multiple and range in size from 1 to 5 mm in diameter. They are usually asymptomatic but can become irritated and bleed with manipulation.
→	Diagnosis √ Best initial test: Clinical. √ Most accurate test: Skin biopsy showing fibrovascular cores covered by normal squamous epithelium.
→	Treatment √ First line: Reassurance. √ Second line: Snip excision or cryotherapy for symptomatic lesions or cosmetics.