Fibroma molle (skin tags) D23.-

Special form of a soft fibroma of the skin. No real tumours, but circumscribed skin protuberances, which occur in age-involuted skin in relation to their localisation.

Occurs in almost everyone after the age of 40.

Occurs in middle and old age, often in obese patients. There is a high association (26%) between muliple axillary fibroma (skin tags) and insulin-resistant diabetes mellitus (Bustan RS et al. 2017).

Neck and intertriginous spaces, especially axillae and groins.

Solitary or more commonly multiple, approximately 0.1-0.5 cm (or larger), skin-colored, red or red-brown, soft skin polyps, usually narrow-based on the skin. They consist of connective tissue with variable epidermal, melanocytic, vascular or lipogenic involvement. If the surface is more keratinized (e.g. due to permanent mechanical irritation), these fibromas are called "fibrokeratoma Unna".

Polypoid growth with a loosened connective tissue stromas, dilated blood and lymph vessels, an overlapping, often slightly acanthotic, otherwise normal epidermis. In mechanically errant fibroma, the surface epithelium may show increased pigmentation.

Excision with scalpel or scissors if necessary. Caution: After removal of the fibroma, especially in the case of larger fibroma, prolonged bleeding may occur.

1. Bustan RS et al (2017) Specific skin signs as a cutaneous marker of diabetes mellitus and theprediabetic
   state - a systematic review. Dan Med J 64: A5316.
2. Garcia Hidalgo L (2002) Dermatological complications of obesity. Am J Clin Dermatol 3: 497-506
3. Ragunatha S et al(2011) Cutaneous disorders in 500 diabetic patients attending diabetic clinic. Indian J Dermatol 56:160-164
4. Sand C (2003) Topical tacrolimus ointment may induce skin tags in treated patients. Acta Derm Venereol 83: 317
5. Twomey P (2002) Skin tags and the atherogenic lipid profile. J Clin Pathol 55: 639