Acrochordon

For years, a 60-year-old obese woman with type 2 diabetes mellitus had this warty lesion on the outer tarsal plate in the middle of the left upper eyelid. It was asymptomatic.

She also had a few asymptomatic epidermal inclusion cysts on the upper and lower eyelids. Acrochordons, or skin tags, are associated with diabetes mellitus, dyslipidemia, acromegaly, acanthosis nigricans and, possibly, colon polyps. The most common sites are the axillae, neck, groin, and eyelids, and the skin beneath pendulous breasts. Acrochordons are particularly common in overweight women; in autopsy series of obese women, approximately 50% were found to have skin tags.¹

Treatment of acrochordons is typically for cosmesis only. This patient’s lesion was excised in the office under local anesthesia, and its base was lightly electrocoagulated.