Background: Skin tags (STs) are benign connective tissue neoplasms, in which insulin-like growth factor −1 (IGF-1) has a mitogenic and antiapoptotic activity. Purpose: We aimed to study for the first time, the possible role of IGF-1 (CA) 19 and rs6214 gene polymorphisms, and its tissue immunoreactivity in the pathogenesis of STs. Patients and methods: This case–control study included 40 ST patients and 20 controls. We searched for (CA) 19 single-nucleotide polymorphism (SNP) using conversional PCR and for rs6214 gene polymorphism using real-time PCR. IGF-1 tissue immunoreactivity was investigated using polyclonal IGF-1 antibody. Results: IGF-1 immunoreactivity showed significantly strong upregulation in epidermis ( p =0.002) and dermal components (endothelial cells [ p =0.038] and fibroblasts [ p =0.004]) of excised STs than control skin. TT and CT rs6214 genotypes and its T allele were significantly associated with STs ( p =0.006 and P =0.002, respectively). Also (<192 bp) and 192–194 bp (CA) 19 genotypes were significantly predominant in ST patients than controls ( p =0.013). These 4 genotypes were significantly associated with development of multiple STs and epidermal IGF-1 tissue immunoreactivity in studied patients. Conclusions: IGF-1 (CA) 19 and rs6214 gene polymorphisms may contribute to a predisposition of STs in Egyptian patients, the role of which could be mediated through local upregulation of IGF-1 in cutaneous tissues.

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Background: Skin tags are flesh-coloured, pedunculated growths with a smooth surface, reported to have an incidence of 46% of the general population. The etiology of skin tags is still unknown, human papillomavirus skin infection is one of the associated factor. Human papillomavirus (HPV) is a small DNA virus of papovavirus family that classified into low risk HPV (6& 11) and high risk HPV (16&18) that induce malignant transformation. presence of HPV in the tissues depends on the identification of viral nucleic acids by PCR than serological methods that can't distinguish between present and past infection of HPV. Objectives: To detect the relationship between human papillomavirus skin infection and skin tags and to asses the relation between low risk and high risk HPV genotypes and skin tags clinical criteria and associated clinical conditions. Methodology:This study was conducted on 40 patients (20 females and 20 males) having skin tags (group I) and 20 sex and age matched subjects free from skin tags (group II). Skin biopsy was taken from each subject and Multiplex Polymerase chain reaction (PCR) was used to detect HPV types 6, 11, 16 and 18 DNA. Results: Family history was statistically significant higher in group I than group II (P=0.002). STs distributions were higher in neck (21, 52.5%) then axilla (11, 27.5%), back (4, 10%), abdomen (2, 5%) and the thigh(2, 5%). A significant difference in HPV positivity between the studied groups, that showed stepwise down regulation from lesional (19, 47.5%) passing by perilesional (5, 12.5%) and ended by normal skin (2, 10%) specimens (P<0.001). Moreover HPV genotype 6 was the most observed type. Conclusion: Human papillomavirus has a role in the pathogenesis of skin tags. Therefore using of antiviral or immunotherapy may help in skin tags management program. There is no relation between HPV genotypes and skin tags clinical criteria (sites & severity) nor associated clinical conditions. METHODOLOGYThis case-control study was conducted on patients (n=40) having variable numbers of skin tags lesions. They were compared with age and sex-matched healthy volunteers (n=20) as a control group. Patients were recruited from the Outpatient Clinic of Dermatology,

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