Q I have noticed a gradual increase in growth of small fleshy things on my neck and armpit. There is no pain or itching. I am a female, 45 and suffer from diabetes. A skin specialist has said these are papillomas and need removal. Please advise and tell me are these cancerous or can they become cancerous?
A The condition you have mentioned is medically known as cutaneous papilloma or acrochordon but the common name for these is ‘skin tags’. Skin tags are benign — they are not skin cancer and cannot turn into skin cancer.
A skin tag consists of a bit of skin that projects from the surrounding skin and may appear attached to the skin. Skin tags can vary quite a bit in appearance, range in size from very tiny to the size of a pencil eraser tip. They may be smooth or irregular, flesh coloured or more deeply pigmented, and either simply be raised above the surrounding skin or have a stalk (a peduncle) so that the skin tag hangs from the skin. There is no known reason for the appearance of skin tags and there is no way to prevent skin tags.
Skin tags can occur almost anywhere there is skin. However, favourite areas for tags are the eyelids, neck, armpits (axillae), upper chest and groin. They are much more common with age, beginning in middle age and they tend to be somewhat more prevalent in women than men. They are also more common in obese and overweight people and in those with Type 2 diabetes mellitus. Usually skin tags cause no problems, they exhibit no symptoms unless they become twisted, repeatedly irritated, or inflamed. It is usually not medically necessary to treat all skin tags, however, in cases in which a skin tag needs removal or is cosmetically unwanted or annoying, treatment may be done by electro cauterization — freezing the tag with liquid nitrogen or cutting off (excising) the tag with a scalpel or scissors. Treated sites heal quickly with minimal or invisible scarring.
DR BADR DHANANI
OMI
Q Every time I get up, particularly after waking up, I seem to black out. I can normally keep it under control, but lately it’s made me collapse. Is this anything I should be worried about or is it normal?
A The condition that you describe is called syncope. Syncope has many causes and needs proper investigation. Syncope can be due to a cardiac cause, which can have serious outcomes and can also be due to other less serious causes.
For this a formal investigation is needed. Your information is not complete therefore it is difficult to ascertain the likely cause and mechanism. If you have been checked by a physician and your examination was normal, your ECG was normal and your BP checked in lying and standing position did not show a BP drop of more than 20 mmHg then you may have a condition called neurocardiogenic syncope (vasovagal syncope), which is something people experience commonly like soldiers falling during assemblies due to prolonged standing.
Older people tend to get a drop in BP when they stand due to failure of the leg arteries to constrict as a normal response to gravity and they experience blackouts and falls. This is called postural hypotension and you would feel it immediately on standing, while neurocardiogenic syncope is experienced a little after getting up and for example walking to the washroom and fainting there while brushing your teeth. This is just a summary of the possibilities and I would suggest a visit to a cardiologist for a proper work-up to rule out the more sinister causes.
Dr Aamir Hameed
AKUH
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Q I have noticed a gradual increase in growth of small fleshy things on my neck and armpit. There is no pain or itching. I am a female, 45 and suffer from diabetes. A skin specialist has said these are papillomas and need removal. Please advise and tell me are these cancerous or can they become cancerous?
