Giant skin tag on the labium majorum

Skin tags, or acrochordon, are one of the most common skin tumors, which are small, soft, skin-colored to drak brown, sessile and pedunculated papilloma (Choudhary, 2008). Most skin tags vary in size from 2 to 5 mm in diameter, and a few unusual giant variants can also be found in the literature (Choudhary, 2008; IIango et al., 2009; Eris Eken et al., 2014). In this study, we describe a rare case with a giant skin tag on the vulva. A 24-year-old woman presented with a painless mass on the vulval area, which developed to large proportion over two years (Figure 1A). The lesion was asymptomatic apart from the slight discomfort to the patient due to the growth. She received a surgery to excise the huge mass completely because of the aesthetic demand. Histopathology of the specimen revealed acanthosis, loosely arranged collagen fibres (Figure 1B). Based on the clinical manifestations and histopathological features, the final diagnosis was giant skin tag of the vulva. Skin tags are seen frequently on the neck and in the axillae, and in skin fold area, such as groin and submammary regions. Less often on the penis and labium majus (Eris Eken et al., 2014). They often increase in number and size with time, but rarely reaching a large size. The exact pathogenesis of skin tag is currently unclear. It may be associated with obesity, some endocrine diseases, diabetes mellitus, insulin resistance, genetic predisposition, carbohydrate and lipid metabolism disorders. Pregnancy is also suspected as a risk factor. Because hormonal changes may affect the development of the lesion (Eris Eken et al., 2014). Abdou et al. reported that mast cells may