Acrochordons as a presenting sign of nevoid basal cell carcinoma syndrome

Background: Nevoid basal cell carcinoma syndrome (NBCCS) is a genodermatosi s with autosomal dominant inheritance. In identified kindreds the diagnosis is relatively easy, but for the patients without family history of this sy ndrome a high clinical suspicion is necessary for diagnosis. Objective: Acrochordons are distinctly uncommon in childhood. Our purpose w as to evaluate skin tags that develop at an early age. Methods: This is a retrospective series evaluation of 7 children who presen ted with pedunculated papules (acrochordon-like growths). A full history wa s then correlated with biopsy results in each patient. Results: Clinically, lesions consisted of flesh-colored and pigmented pedun culated papules. Histopathologic examination of these papules showed basal cell carcinomas in each biopsy specimen. Conclusion: We consider that "skin tag"-like basal cell carcinomas in child hood may represent a marker for NBCCS. Early diagnosis of this syndrome and early sun protection of the affected children could help decrease the numb er of lifetime tumors. Biopsy should be performed on acrochordons in childr en because they may be the presenting sign of NBCCS. Because these tags may precede other stigmata of the NBCCS, recognition may facilitate early diag nosis and allow early treatment and sun protection.