Rasi 2007: Skin Tags and Diabetes

Background

Dr. A. Rasi and colleagues published this case-control study in the International Journal of Dermatology (PMID: 17988334), examining skin tags as a cutaneous marker for impaired carbohydrate metabolism.

Study Design

Design: Case-control study Cases: 104 patients with multiple skin tags (≥3) Controls: 98 age/sex-matched patients without skin tags Measurements: Fasting glucose, OGTT, fasting insulin, HOMA-IR Analysis: Prevalence of diabetes and prediabetes between groups

Key Findings

Diabetes prevalence:

Group	Diabetes Rate	P value
Skin tags	23%	—
Controls	8.5%	<0.01

By skin tag count:

Number of Skin Tags	Diabetes Rate
3-5	15%
6-30	26%
>30	52%

Other findings:

• •Mean fasting glucose higher in skin tag group
• •Fasting insulin significantly elevated
• •HOMA-IR elevated (indicating insulin resistance)

Mechanistic Insights

Skin tags develop due to:

1. •High insulin stimulating IGF-1 receptors on fibroblasts
2. •Increased fibroblast proliferation
3. •Growth of skin appendages

They are a visible manifestation of tissue-level hyperinsulinemia.

Clinical Implications

Multiple skin tags on physical exam should prompt:

• •Fasting glucose and insulin testing
• •HOMA-IR calculation
• •HbA1c measurement
• •Metabolic syndrome screening

Cost-effective early detection method.

Metabolic Health Perspective

Skin tags join acanthosis nigricans as physical exam findings that indicate hyperinsulinemia before glucose abnormalities develop. Their presence in normal-weight individuals suggests metabolically obese phenotype requiring evaluation.