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• W1974528028 abstract "Editor Fibroepithelial polyps, commonly designated as skin tags or acrochordons, are benign skin lesions composed of loose fibrous tissue. The average diameter of these asymptomatic, pedunculated, soft, round, inelastic nodules are around 2 mm,1 but larger lesions (the so-called giant skin tags) are rarely seen. We are reporting here a case series of four patients with giant skin tags because of their rarity and unusual locations. Our first patient, a 32-year-old female presented with a slowly growing, asymptomatic, brownish-black polypoid globular pedunculated mass, measuring about 3 cm × 2.5 cm in size and hanging down from her left nipple with a long fibrous stalk (Fig. 1). The lesion was soft to touch, inelastic and non-tender, and lobulated in appearance. The second patient, a 28-year-old pregnant woman had almost a similar lesion on identical location, which was present for 6 years but grew rapidly during pregnancy. The third patient was a 36-year-old male who presented with a blackish, slowly growing mass hanging from his right eyelid for 5 years and which was gradually hindering his vision. It was a 0.5 cm × 2 cm, hyperpigmented and pear-shaped polypoid pedunculated mass with a lobulated surface hanging from the middle of his right eyelid. The fourth patient, a 28-year-old man, was very apprehensive of a rapidly growing mass on the back of his right thigh for last 2 years. He used to have discomfort on walking and putting on clothing. A 2.5 cm × 2.5 cm sessile, polypoid globular mass with lobulated surface was seen on the middle of the posterior aspect of his right thigh. All the cases were treated with radiofrequency surgical removal with excellent cosmetic results. Histopathology of the removed masses in all the cases were consistent with the features of skin tags in the form of thin epidermis with flattened basal cell layer, papillomatosis, irregular acanthosis, loose collagen fibres and dilated capillaries. Showing a brownish-black, pedunculated giant skin tag with lobulated surface, on the left nipple. Although skin tags involve nearly 46% of the general population,2 there are only a few case reports or case series of giant skin tags found in the existing literature. The gender distribution of the disease is equal. They mostly affect peri-menopausal and postmenopausal women. Although familial affection may sometimes occur, none of our patients had the same. The sites of predilection of skin tags are neck, face, major flexures like axillae and very rarely the male and female genitalia,3 the oral mucosa and anus.4 To the best of our effort, we could not find any documentation regarding the occurrence of giant skin tags on nipples (as seen in case 1 and case 2 in this series). Small sessile lesions of seborrhic keratosis may coexist with skin tags. One of our patients had similar lesions on her face (case 1). Some recent study has pointed out the relationship of skin tags with impaired glucose tolerance5 and obesity. But none of our patients had systemic associations, and none of them had any additional skin tags on other sites of the body. The differential diagnoses should include warts, pedunculated seborrheic keratosis and neurofibromatosis. Skin tags are benign tumours and are often considered clinically insignificant cutaneous redundancies, which should be removed without histopathological analysis. However, another neoplasm like basal or squamous cell carcinoma can rarely be found within a skin tag. An acrochordon containing squamous cell carcinoma has been described in literature that clinically resembled keratoacanthoma.6 Both electrocautery and cryotherapy with liquid nitrogen are usually curative. Simple excision may be needed in case of a larger lesion. Long-standing skin tags may become vascularized, fibrous or ischemic.3 No such changes, however, had been noticed in any of our patients." @default.
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• W1974528028 date "2009-01-20" @default.
• W1974528028 modified "2023-10-12" @default.
• W1974528028 title "Giant skin tags on unusual locations" @default.
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• W1974528028 doi "https://doi.org/10.1111/j.1468-3083.2008.02816.x" @default.
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