A clinicoepidemiological study of skin tags and their association with metabolic syndrome

Abstract

Introduction. Skin tags are known to be associated with several systemic diseases such as diabetes mellitus, obesity, dyslipidemia and cardiovascular diseases. Only a few Indian studies have investigated patients with skin tags for underlying metabolic complications. Objective. To assess the clinico-epidemiological profile of patients with skin tags and evaluate them for underlying metabolic abnormalities. Material and methods. All the patients reporting skin tag(s) at the dermatology outpatient department from October 2013 to September 2014 were included in the study. A detailed general, cutaneous and systemic examination was carried out. The data were analyzed using the c 2 test. A p-value < 0.05 was considered significant. Results. Out of 165 enrolled patients, 112 (67.88%) completed the study protocol. Females outnumbered males, the M : F ratio being 1 : 1.11. Most patients (32; 28.57%) were in the age group of 31-40 years. The majority of the patients (77; 68.75%) reported after 1 year of noticing the lesions. The most commonly affected site was the neck (99; 88.39%) followed by the axilla (53; 47.32%). Acanthosis nigricans was the most common skin disease associated with skin tags (37; 33.03%). The diagnostic criteria for metabolic syndrome were fulfilled by 47 (41.96%) patients. The majority of the patients (70; 62.5%) were either overweight or obese. Abnormal glucose tolerance and hypertension were found in 41 (36.6%) and 37 (33.03%) of the patients respectively. Above optimal LDL cholesterol was the most common lipid abnormality, detected in 64 (56.25%) of the cases. Patients with 11 or more skin tags lesions and those with involvement of the thigh, axilla or neck were more likely to have metabolic syndrome. Conclusions. Patients with skin tags should be screened for concomitant diseases such as diabetes, hypertension, dyslipidemia and cardiovascular disease. Early detection of these complications followed by appropriate lifestyle changes and/or drug therapy would be beneficial in terms of reducing the considerable morbidity and mortality.

Acrochordon as a marker of metabolic syndrome – A cross-sectional study from South India

“…Increased waist circumference was noted in a majority (77%) of cases, but there was no significant difference from control group, which was contradictory to the previous studies. [10,12] However, on calculating BMI, 42% of the cases were overweight and 12% were obese which were significant and in accordance with other studies. [8,13] Plausible mechanisms for higher prevalence of acrochordons in obesity are hyperinsulinemia and increased leptin levels.…”

“…[8,9] Our observation of 65% of cases manifesting metabolic syndrome was higher than the 42% noted in the previous studies from South India in patients with acrochordons as well as in other diseases like psoriasis. [10,11] We found that increased waist circumference (77%), high FBS (61%), high BP (45%), and low levels of HDL (42%) contributed to a higher percentage of metabolic syndrome in our cases with acrochordons.…”

“…One previous study found no significant association between the two. [10] We found that patients with sessile acrochordons were less likely to manifest metabolic syndrome (P < 0.001) or its components such as increased waist circumference (P < 0.001), elevated triglyceride level (P = 0.02), low HDL (P < 0.001), and elevated plasma glucose level (P = 0.002) in comparison to those with other morphological types.…”

“…[18] We observed a high prevalence of hypertension in 45% of cases while a previous Indian study reported a frequency of 33% for the same. [10] Srivastava et al, reported that lesions over thigh, neck, and axilla were more likely to have metabolic syndrome. [10] is was contrary to our observation of cases manifesting acrochordons limited to axilla showing a significant negative association with metabolic syndrome and its components such as abnormal waist circumference (P < 0.001), elevated triglyceride level (P = 0.01), high BP (P = 0.004), and elevated fasting plasma glucose level (P = 0.03) when compared to those who had lesions on other body sites with or without involvement of axilla.…”