Background
Skin tags, also known as acrochordons, fibroepithelial polyps, or soft fibromas, are benign pedunculated papules or tumours that are made up of collagen fibres and blood vessels surrounded by a thin or thickened epidermis. There is a familial disposition and association with obesity and type 2 diabetes mellitus. It is not known what causes skin tags.
Signs and symptoms
Skin tags are mostly asymptomatic. They are commonly located on eyelids, neck, axillae, and the groin and range from 1mm to 5cm in size. Skin tags in front of the ear (preauricular) can occur by themselves or may occur in association with genetic syndromes such as Goldenhar syndrome.
Diagnosis
Diagnosis is based on clinical examination and are typically found at birth. Skin tag-like lesions may be a feature of a genetic syndrome, which can be differentiated histologically.
Differential diagnoses:
- Molluscum contagiosum
- Viral warts
- Seborrheic keratoses (more in adults)
Management
Although skin tags are usually benign, they can become irritated or necrotic. Patients often request removal for cosmetic reasons. Methods of removal include cryotherapy, surgical excision, diathermy or ligation (tying string around the tag to reduce blood flow until the tag falls off).
References
Paller, A., Gilchrest, B. A., Katz, S. I., Leffell, D. J., Wolff, K., Goldsmith, L. A. (2012). Fitzpatrick’s Dermatology in General Medicine, Eighth Edition, 2 Volume Set. United States: McGraw-Hill Education.
Low, D., 2022. Ear Tags – Children’s Hospital of Philadelphia. [online] Chop.edu. [Accessed 19 October 2022].
Oakley, A., 2004. Skin tags. Acrochordons – DermNet. [online] Dermnetnz.org. Available at: <https://dermnetnz.org/topics/skin-tag> [Accessed 19 October 2022].