Acrochorda

Acrochorda, or acrochordon, is a common benign skin lesion also known as a skin tag or fibroepithelial polyp. It is a soft, pedunculated outgrowth of skin that originates at the dermal-epidermal junction and is usually flesh-colored or slightly pigmented.

Most lesions are small (often 1–5 mm but sometimes larger) and grow slowly. They occur in areas where the skin experiences friction or moisture, especially the neck, armpits, groin, upper eyelids, and under the breasts. They tend to appear in middle age and are more common in people who are overweight or have type 2 diabetes or insulin resistance; pregnancy can also increase risk.

Pathophysiology is not fully understood; acrochordae are composed of fibrous tissue with blood vessels and a covering of epidermis. They are typically asymptomatic but may become irritated by clothing or jewelry, leading to itching or bleeding.

Diagnosis is clinical. A clinician can usually identify acrochordons by appearance. If the lesion has atypical features such as rapid growth, ulceration, color change, or irregular borders, biopsy or dermoscopy may be considered to exclude other conditions such as neurofibromas, seborrheic keratosis, or skin cancer.

Management is usually optional. Removal is sought for cosmetic reasons or to prevent irritation. Common techniques include snip excision with local anesthesia, cold coagulation, cryotherapy, or surgical excision. Ligation or topical adhesive agents may also be used. Recurrence is possible but not common.

Prognosis is excellent; lesions are benign and do not predispose to skin cancer. They can recur at the same site or in other areas.