Achrochordons as a cutaneous sign of insulin resistance

Abstract

Achrochordons, commonly known as skin tags, are common benign connective tissue tumors of the dermis, composed of loose fibrous tissue. It presents as a soft, skin-coloured to slightly hyperpigmented papule. Aims: To study achrochordons as a cutaneous sign of insulin resistance. Methods: A hospital based, cross-sectional prospective study was conducted on 100 patients with clinically diagnosed achrochordons conducted in the Dermatology outpatient department between January 2017 and June 2018 (18 months). Patients having more than or equal to 5 skin tags anywhere on their body were included in the study. Patients <18 years of age, pregnant and lactating women and patients with a known colonic polyposis disease were excluded from the study. A thorough history taking and examination with respect to the onset, site, duration and progression of achrochordons was taken. The homeostatic model assessment (HOMA) was used to quantify insulin resistance (IR) in these patients. A cut-off value of 2.5 or more signified presence of insulin resistance. Results: Most patients (81 out of 100) were seen to have HOMA-IR values equal or more than 2.5. 44.4% of patients with HOMA-IR more than 2.5, had 5-10 achrochordons. The most common age group in patients with HOMA-IR more than 2.5 was 31 to 40 years (39.5%) followed by 41 to 50 years (29.6%) and 18 to 30 years (19.8%) . Conclusion: Although there have been plenty of studies from the West reporting skin tags as a cutaneous sign of insulin resistance, there are no large scale Indian studies evaluating Asian patients. The present study was an endeavour in this regard. We may propose that skin tags may be one of the important skin markers of metabolic disorders and may attract physicians and dermatologist for further investigation as it is proved to be not just a cosmetic problem.