SKIN TAGS
Medical Skin Care | Skin Tag Removal
Benign skin tumors are commonly seen by family physicians. The ability to properly diagnose and treat common benign tumors and to distinguish them from malignant
lesions is a vital skill for all family physicians. Any lesions for which the diagnosis is uncertain, based on the history and gross examination, should be biopsied for histopathologic examination to rule out malignancy. Diagnosis usually is based on the appearance of the lesion and the patient’s clinical history, although biopsy is sometimes required. Treatment includes excision, cryotherapy, curettage with or without electrodesiccation, and pharmacotherapy, and is based on the type of tumor and its location. Common treatments for acrochordons and seborrheic keratoses are cryotherapy and shave excision. Referral is indicated if the family physician is not confident with the diagnostic evaluation or treatment of a lesion, or if a biopsy reveals melanoma.
Acrochordon
Acrochordons, or skin tags, are derived from ectoderm and mesoderm and represent a hyperplastic epidermis. They are found in 25 percent of persons and increase in number with age. Obesity is a predisposing factor.18 The axilla, neck, and inguinal region are the most common sites. Skin tags usually are attached to the skin by a thin stalk (pedunculated) but also can be sessile. They range in size from less than 1 mm to 1 cm in diameter and are skin-colored or brown.
Differentiating seborrheic keratoses from melanomas can be challenging, but melanomas tend to display more color variation and a smoother surface.
Skin tags pose no malignant threat in adults, but treatment is appropriate for cosmesis or because of irritation. Simple electrocautery or scissor excision at the base of the stalk is sufficient. Local anesthesia usually is not necessary. Cryotherapy is effective for small lesions. However, recurrences of skin tags are common. Pathologic evaluation is unnecessary unless skin tags are present in childhood, because they may be the initial presentation of nevoid basal cell carcinoma syndrome.
For further information or research see the links below:
Family physicians frequently encounter patients with dermatologic diseases, either as the primary complaint or as a “by the way.” Therefore, the ability to accurately diagnose and treat benign skin lesions is an important skill that family physicians should possess. Options for evaluating patients with benign skin tumors can be categorized according to the morphologic characteristics of each lesion: macular or slightly raised/papular (Figure 1), papular (Figure 2), or subepidermal (Figure 3).
|
|||||||||||||||
|
|||||||||||||||
 |
||
| Approach to Benign Skin Tumors (Subepidermal) | ||
NOTE: Selected common skin tumors included. Many other less common entities exist. |
||
| FIGURE 3. Algorithm for the diagnosis of benign skin tumors (subepidermal). | ||
|
Skin Deep Cosmetic Safety Database by Environmental Working Group
WebMD Healthcare information site
www.health.gov is a portal to the Web sites of a number of multi-agency health initiatives and activities of the U.S. Department of Health and Human Services (HHS) and other Federal departments and agencies
Office of Disease Prevention and Health Promotion
Healthfinder.gov - daily health news, quick guide to healthy living, sponsored by the National Health Information Center
Medline Plus - Health Information - A service of the U.S. National Library of Medicine and the National Institutes of Health
