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Acrochordon Workup

  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
Updated: Jun 10, 2016

Imaging Studies

A congenital perineal skin tag manifested as a perineal tumor during a second-trimester ultrasound scan at 23 weeks' gestation.[36] It was an innocuous finding.


Histologic Findings

Acrochordons are characterized by acanthotic, flattened, or frondlike epithelium. A papillarylike dermis is composed of loosely arranged collagen fibers and dilated capillaries and lymphatic vessels (see the images below). Appendages are generally absent. Acrochordons were thought to be marked by decreased numbers of elastic fibers, though one study of elastic tissue in FEPs showed no deficiency of this tissue.

A hyperplastic epidermis showing papillomatosis, hA hyperplastic epidermis showing papillomatosis, hyperkeratosis, and acanthosis overlying loosely arranged collagen fibers and many capillaries.
A higher-power view demonstrating to better advantA higher-power view demonstrating to better advantage loosely arranged collagen fibers and many capillaries.

Acrochordons (skin tags) are often considered clinically insignificant cutaneous redundancies that should be removed without histopathologic analysis.[37] However, one may rarely find another neoplasm within an acrochordon. A squamous cell carcinoma that had features resembling a keratoacanthoma was recently described.[30]

Contributor Information and Disclosures

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.


Wanda M Patterson, MD Department of Dermatology, UMDNJ-New Jersey Medical School

Wanda M Patterson, MD is a member of the following medical societies: Sigma Xi

Disclosure: Nothing to disclose.

Agnieszka Terlikowska, MD Staff Physician, Department of Dermatology, Medical University of Warsaw, Poland

Disclosure: Nothing to disclose.

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A 53-year-old man with multiple, small, axillary skin tags.
A hyperplastic epidermis showing papillomatosis, hyperkeratosis, and acanthosis overlying loosely arranged collagen fibers and many capillaries.
A higher-power view demonstrating to better advantage loosely arranged collagen fibers and many capillaries.
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