Skin Tags and Thyroid Nodules Connected?

According to recent findings published on PubMed, a service of the U.S. National Library of Medicine and the National Institutes of Health, high prevalence of thyroid nodules have been found in patients with achrocordons (skin tags) and can indicate a possible role of insulin-resistance.

Excerpts from various published articles and comments follow below. From the Centro Privado de Endocrinología, Mendoza:

“Due to the observation of a great number of patients having achrocordons, when they underwent fine needle biopsies for thyroid nodules, we decided to perform a prospective study to investigate the relationship between this finding and the presence of insulin resistance (IR), since achrocordons are commonly seen in hyperinsulinemic subjects.

A total of 120 consecutive women, aged 18-35 yrs were studied. All subjects were also evaluated by thyroid ultrasound (US) for measuring thyroid volume and the presence of non-palpable nodules. Basal and post-prandial serum insulin was measured in all of them, as well as the Homeostasis Model Assessment (HOMA).

Subjects were divided in two groups: Group A, with achrocordons (n = 44) and Group B, without achrocordons (n = 76). Group A showed 24 patients (54.5%) with thyroid nodules, whereas Group B only 13 subjects (17.1%); p = 0.0087. When we considered, as having high normal thyroid volume, the glands weighting more than 16 grams by US, without nodules, it was found that 8/44 cases from Group A (18.6%) and 3/76 from Group B (3.9%) fitted in such category, p = 0.0076.

In patients with nodules and/or bigger thyroids, IR was observed in 36/44 (81.8%) of Group A and 14/76 (18.4%) of Group B, p = 0.0069, while the overall prevalence of IR was 0.47 in Group A and 0.05 in Group B, p = 0.00094. It is concluded that patients with achrocordons have a higher prevalence of US-detected thyroid nodules and larger thyroid glands. Then, it may be beneficial to search for thyroid abnormalities in those subjects with skin tags.”

A question followed from the Dermatology Department, Shiraz University of Medical Science, Shiraz, Iran.

“Is there any relation between serum insulin and insulin-like growth factor-I in non-diabetic patients with skin tag?”

Answer: Jowkar F, Fallahi A, Namazi MR.

Abstract Background Skin tags are common benign lesion occurring mainly on the neck and major flexures as a small soft pedunculated protrusion. This study evaluate insulin and insulin-like growth factor-I (IGF-I) in non-diabetic ones. Methods and materials A case-control study was conducted in non-diabetic persons. Comparing insulin and IGF-I between matched cases (n= 40) and controls (n= 40) by radioimmunoassay test.

Cases and controls were recruited from patients consecutively seen at an academic outpatient dermatology clinic. Results The insulin level in patients with skin tags was significantly higher than controls (P = 0.00) but IGF-I level was not significantly different (P = 0.43). Conclusion These results show an increased insulin level in non-diabetics ones and overall importance of insulin effect in pathogenesis of skin tags.

Conflicts of interest None declared.

Skin Tags and Impaired Carbohydrate Metabolism

Following up with a previous report on the correlation between high numbers of achrocordons (skin tags) and a possible role of insulin-resistance, a 2007 case-controlled study was published on PubMed, (a service of the U.S. National Library of Medicine and the National Institutes of Health), examining skin tags as a cutaneous marker for impaired carbohydrate metabolism.

Excerpts from the team’s findings are published below.

Department of Dermatology, Hazrat-e Rasool Akram University Hospital, Iran University of Medical Sciences, Tehran, Iran. Rasi A, Soltani-Arabshahi R, Shahbazi N.

BACKGROUND: Skin tags are common benign skin tumors usually occurring on the neck and major flexors of older people. A possible association with impaired carbohydrate metabolism has been suggested in previous studies, but the results are not conclusive.

OBJECTIVE: To investigate and compare the prevalence of diabetes and impaired glucose tolerance (IGT) in patients with skin tag and a control group.

PATIENTS AND METHODS: A case-control study was conducted in individuals over 15 years old, comparing cases (n = 104) with at least three skin tags and age-, sex-, and body mass index (BMI)-matched controls (n = 94) without skin tag. Cases and controls were recruited from patients consecutively seen at an academic outpatient dermatology clinic. All patients underwent a standard 2-h oral glucose tolerance test with 75 g glucose.

RESULTS: Patients with skin tag had higher frequency of diabetes than the control group (23.07% vs. 8.51%, chi(2)-test, P = 0.005). The difference in the frequency of IGT was not significant (13.46% vs. 10.63%, chi(2)-test, P = 0.543). There was a positive correlation between the total number of skin tags and the mean fasting plasma glucose (Pearson correlation, r = 0.260, P = 0.031); patients with more than 30 skin tags were particularly at an increased risk of diabetes (52.0%). No correlation was found between the number of skin tags and BMI. We did not find any correlation between the anatomical localization of skin tags and impaired carbohydrate metabolism, except for skin tags under the breast in women.

CONCLUSION: These results show an increased risk of diabetes mellitus in patients with multiple skin tags. With regard to the importance of early diagnosis of diabetes, we recommend a high level of suspicion for impaired carbohydrate metabolism in patients with skin tag.

Source: PMID: 17988334 [PubMed - indexed for MEDLINE