BACKGROUND: Acrochordons are pedunculated papules or nodules with a soft consistency and smooth contour, sometimes apparently growths often hang on thin stalk, with the most acrochordons size was 2–5 mm. Occasionally, due to frictions of the pedicle, acrochordon can become inflamed, tender, and even gangrenous.
CASE PRESENTATION: We report a case series of three giant acrochordons, first case, 19-year-old female come to my OPD clinic with a big mass on her left vagina, with pain and hot while being touched, and fever. On examination big nodule on the right labia mayor was found, with diameter 20 × 20 cm, short stalk, firm, warmed, and pain sensation while touched, with several excoriated skin surface. Second case, 23-year-old female presented in my OPD with a mass in her left vagina, associated with pain and several bleeding spots while being touched, with diameter of 5 × 5 cm. Third case, 31-year-old female consulted to OPD clinic with a year of history having a mass on her right buttock, which gradually increases in size and causing a light pain. On examination, short pedunculated nodule was found at the right buttock, diameter 10 × 6 cm, oval shape, firm, and several excoriated plaques. All cases were diagnosed as giant acrochordons and were performed excision. The previous studies state that the larger lesions of acrochordons in the groin or upper thighs maybe associated with diabetes mellitus and obese individuals. Due to the twisting or strangulated of the pedicle, all three cases of giant acrochordons become inflamed, tender, irritated, infarction, and even gangrenous. In general, it was advised to have the acrochordons removed, particularly in the skin fold of axillae, groin, or vagina, since they will gradually develop in size.
CONCLUSION: Giant acrochordons usually relate to the growth hormone like activity. Hence, they may associate with endocrine disorder. It may occasionally become inflamed, tender, and even gangrenous due to frictions. General principle is to have the acrochordons removed, particularly in skin fold area.