Acrochordon Differential Diagnoses

Updated: Jun 02, 2017
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
  • Print
DDx

Diagnostic Considerations

Also consider the following:

  • Pedunculated seborrheic keratosis
  • Nodular exophytic (polypoid) melanoma
  • Pseudosarcomatous polyp [27]

Rarely, a tick infestation may simulate a necrotic acrochordon. [28] Metastatic melanoma may be first evident as an infarcted acrochordon. [29] Squamous cell carcinoma may rarely be found within an acrochordon. [30] Skin tag–like basal cell carcinomas in childhood may be a marker for basal cell nevus syndrome. [31] Dermatoscopic evaluation may be of value when they are suspected, although the diagnosis of a cancer is always histologic [32]

An aggressive gross squamous cell carcinoma mass arising from a large pedunculated acrochordon located at the lower limb was recently described. [33]

An atypical lipomatous tumor classified as a well-differentiated liposarcoma located within dermis may rarely present clinically as a skin tag,{ref32 as may nevus lipomatosis cutaneous superficialis, an unusual benign hamartomatous disorder. [34]

Mycosis fungoides has also been documented to involve an acrochordon in a patient with known mycosis fungoides. [35] Other cancers have been rare described. [36]

Patients with skin tags might be screened for diabetes, dyslipidemia, hypertension, and cardiovascular disease. [37]

Differential Diagnoses