Acrochordon Differential Diagnoses

Updated: Apr 07, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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DDx

Diagnostic Considerations

Also consider the following:

  • Pedunculated seborrheic keratosis
  • Nodular exophytic (polypoid) melanoma
  • Pseudosarcomatous polyp [31]

Rarely, a tick infestation may simulate a necrotic acrochordon. [32] Metastatic melanoma may be first evident as an infarcted acrochordon. [33] Squamous cell carcinoma may rarely be found within an acrochordon. [34] Skin tag–like basal cell carcinomas in childhood may be a marker for basal cell nevus syndrome. [35] Dermatoscopic evaluation may be of value when they are suspected, although the diagnosis of a cancer is always histologic [36]

An aggressive gross squamous cell carcinoma mass arising from a large pedunculated acrochordon located at the lower limb was recently described. [37]

An atypical lipomatous tumor classified as a well-differentiated liposarcoma located within dermis may rarely present clinically as a skin tag, [38] as may nevus lipomatosis cutaneous superficialis, an unusual benign hamartomatous disorder. [39]

Mycosis fungoides has also been documented to involve an acrochordon in a patient with known mycosis fungoides. [40] Other cancers have been rare described. [41]

Patients with skin tags might be screened for diabetes, dyslipidemia, hypertension, and cardiovascular disease. [42]

Differential Diagnoses