sessile seborrheic keratosis.⁽⁴⁾ These flesh coloured teardrop-shaped tags, feel like small bags. Based on twisted pedicle, they become inflamed, tender and even gangrenous. Both sexes are affected equally. Skin tags usually grow as we age. Increasing number of skin tags was seen with the increase in weight and pregnancy. Skin tags may occur at unusual sites of the body. A huge skin tag have been described on the penis.⁽⁵⁾ A skin tag on the glans penis unassociated with condom catheter use has also been described.⁽²⁾ Skin tags of the oral mucosa, anus and vulvovaginal areas may be found.⁽⁶⁾ The symptoms are asymptomatic. Sometimes, they become painful due to irritation or torsion.⁽³⁾ Sometimes, pruritus or discomfort occur when an acrochordon is snagged by jewellery or clothing.⁽⁶⁾ There are many studies where an association have been found between acrochordons with conditions such as obesity, diabetes mellitus, atherogenic lipid profile, acromegaly and Crohn’s disease.⁽⁷⁾ About 30% and 65% of adults were found overweight, obese or having abdominal obesity in various surveys in urban India.⁽⁸⁾ The factors, which contribute for diabetes, dyslipidaemia and cardiovascular disease are abdominal obesity and insulin resistance.^(9,10) Although, many disorders are considered to be accompanied by skin tags, no sufficient studies have been conducted to assay the real risk. This survey was designed to evaluate the risk of dyslipidaemia in people with acrochordons in normal population. Along with these, the addition of fast foods and sedentary lifestyle with no exercise in this busy world needs due mention in the increase of obesity.

Aims and Objectives

1. Can acrochordons be a marker of metabolic syndrome?
2. To find out the association of lipid profile, fasting blood glucose, HbA1c, lipid profile and BMI with acrochordons.

MATERIALS AND METHODS

Study Design

This was a descriptive comparative study with a simultaneous comparison group. The study was conducted in Calcutta National Medical College, Kolkata, during July 2016 to December 2016.

Duration of Study

6 months (July to December 2016).

Sample Size

50 cases with acrochordons was finally included and 50 age-sex matched individuals who did not have acrochordons, but had come to the Department of Dermatology with other skin problems were included in the comparison group.

Sample Size Determination

All cases of acrochordons who attended the Department of Dermatology were included in the study after obtaining their informed consent. In this way, 50 cases with acrochordons could be detected during the study period and thus the sample size came about to 50. Comparison group was selected after matching age and sex with cases who attended Dermatology OPD with other skin problems, but not having acrochordons and who met the inclusion criteria.

Selection of Cases and Comparison Group

Inclusion Criteria

1. All patients, both cases and comparison group age-sex matched were taken from the Department of Dermatology, Calcutta National Medical College, Kolkata-14.
2. Patients with at least 3 skin tags were included in the study and served as cases. A skin tag is a soft, skin-coloured growth that hangs from the skin on a thin piece of tissue called a stalk. A skin tag is defined as a furrowed, pedunculated skin coloured papule approximately 2 mm in width and 3-6 mm in height with a duration of lesions of at least 6 months duration.
3. All patients within the age of 30-50 years of age.
4. Patients were not established diabetic.
5. Individuals who attended the Department of Dermatology with some other dermatological problems, but did not have skin tags or acrochordons served as comparison group. They were examined by the doctors in the Outpatient Department of Dermatology and after being examined free from skin tags or acrochordons were included to be the comparison for the study. They were in the age group of 30-50 years and their age and sex were matched with the cases. The comparison group were non-diabetic persons without acrochordons or skin tags, but having other skin problems who visited the Department of Dermatology during the study period.

Exclusion Criteria

1. Pregnant women, patients with conditions causing fluid retention like heart failure, renal disease (failure) and decompensated liver disease, patients with neurological conditions, thyromegaly were excluded. These interfere with measurement of anthropometric features.
2. Patients who are known diabetic and receiving anti-diabetic drugs.
3. Those persons who are having drugs with a known hyperlipidaemic effect.
4. Hypertensive patients on antihypertensive drugs, which have antihypertensive effect.

Measurement of Various Anthropometric Parameters

Blood pressure, height, weight, waist circumference, hip circumference and body mass index.

Measurement of biochemical parameters- Fasting blood glucose, HbA1c, serum HDL, serum LDL, serum cholesterol and serum triglyceride was analysed. Low-Density Lipoprotein (LDL) cholesterol and Very Low-Density Lipoprotein (VLDL) cholesterol values were calculated according to the following formulae- a) Very low-density lipoprotein cholesterol = triglyceride/5. b) Low-density lipoprotein cholesterol = cholesterol- (very low-density lipoprotein cholesterol + high-density lipoprotein cholesterol). Blood was collected after twelve hours of fasting. Blood collection was done after each patient and comparison was thoroughly examined in the Department of Dermatology after fulfilling the criteria required for the study and comparison groups. All these parameters were measured by autoanalyzer in the Department of Biochemistry, Calcutta National Medical College, Kolkata-14. BMI (basal metabolic index) was calculated by dividing body weight to height square (kg/m2). Patients were considered according to their BMI- BMI ≤18 as thin, BMI between 19 and 25 as normal, BMI between 26 and 29 as overweight, BMI ≥30 as obese. The height of patients was measured by a measuring tape. The measurement was approximated to the nearest 0.5 cm. The weight of the cases and comparison were measured by a weight measuring device. The patient and the comparison groups were informed nicely about the aim and procedure of the study. Only willing patients and subjects for comparison were included in the study after having their informed consent.

Statistical Analysis

Data collected was analysed by SPSS (statistical package for social scientist) version 16. The results were expressed as mean ± SD values. The data was recorded in Microsoft excel and analysed using SPSS software (version 16). The significance of the difference between the groups was assessed by Student’s t-test (two tailed, independent) to find the significance of the study parameters between the cases and the comparison groups.

RESULTS

A total of 50 patients (cases) with at least 3 skin tags and age between 30-50 years from the Outpatient Department of Dermatology, Calcutta National Medical College, Kolkata-14 were included in the study. 50 comparisons were also selected for the study after being examined in the Department of Dermatology, Calcutta National Medical College, Kolkata-14. The study was conducted in a period of six months. Patients showed significantly higher levels of glucose (p value = 0.000) and HbA1c (p value = 0.04) levels. Statistically significant p values (p value = 0.000) were also found in cholesterol, high-density lipoprotein, low-density lipoprotein, very low-density lipoprotein and triglyceride levels in the study group than in the comparison group. All patients also showed significantly higher body mass index when compared to comparison group (p value = 0.000).