Acrochordon Differential Diagnoses

Updated: Apr 23, 2018
  • 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 [29]

Rarely, a tick infestation may simulate a necrotic acrochordon. [30] Metastatic melanoma may be first evident as an infarcted acrochordon. [31] Squamous cell carcinoma may rarely be found within an acrochordon. [32] Skin tag–like basal cell carcinomas in childhood may be a marker for basal cell nevus syndrome. [33] Dermatoscopic evaluation may be of value when they are suspected, although the diagnosis of a cancer is always histologic [34]

An aggressive gross squamous cell carcinoma mass arising from a large pedunculated acrochordon located at the lower limb was recently described. [35]

An atypical lipomatous tumor classified as a well-differentiated liposarcoma located within dermis may rarely present clinically as a skin tag, [36] as may nevus lipomatosis cutaneous superficialis, an unusual benign hamartomatous disorder. [37]

Mycosis fungoides has also been documented to involve an acrochordon in a patient with known mycosis fungoides. [38] Other cancers have been rare described. [39]

Patients with skin tags might be screened for diabetes, dyslipidemia, hypertension, and cardiovascular disease. [40]

Differential Diagnoses