Veterinary Dermatology 2003, 14, 177179

Case report

Blackwell Publishing Ltd.

Acrochordonous plaques in two Bulldogs and a Pug dog

A. P. BIDAUT*, T. L. GROSS, C. NOLI, M. WELLE* and M. M. SUTER*
*Institute of Animal Pathology, University of Berne, Laenggassstrasse 122, Postfach, CH-3001 Berne,
Switzerland
California Dermatopathology Service and IDEXX Veterinary Services, West Sacramento, CA 95605, USA
Studio Dermatologico Veterinario, Via Sismondi 62, 20133 Milano, Italy
(Received 25 September 2002; accepted 13 January 2003)

Abstract Acrochordons or fibroepithelial polyps are exophytic to pedunculated tumour-like lesions of the skin
reported to occur in humans and animals. We report here a new and unusual presentation of numerous, closely
associated acrochordons forming a plaque, preferentially located at the dorsal neck of two Bulldogs and a Pug
dog. Histopathologically these plaques were characterized by oedematous to fibrous cores enclosed by normal
to moderately hyperplastic epidermis. We propose the name acrochordonous plaque to reflect the clinical lesion
and the histopathological appearance of numerous, closely spaced acrochordons. Although the aetiology of these
lesions remains unclear, there may be a breed predisposition for Bulldog-like breeds.
Keywords: acrochordon, dog, plaque, polyp, skin tag.

INTRODUCTION
In humans, acrochordons, also referred to as skin tags,
cutaneous tags, soft fibromas and fibroepithelial
polyps, are tumour-like lesions of the skin occurring as
single or multiple exophytic to pedunculated masses
composed of dermal and epidermal tissues.13 Although
they are very common in people (6070% of elderly
individuals are affected)2 these tumour-like lesions are
uncommon in dogs and cats.4,5
Plaque-like skin tag formation has not been
reported, to the best of our knowledge. Here we describe
a new clinical entity, consisting of numerous closely
associated acrochordons forming a plaque on the neck
of two Bulldogs and a Pug dog. Based on the clinical
and histopathological appearance we propose the
name acrochordonous plaque.

CASE HISTORY
Case 1 was a 6-year-old-male Pug dog with a more than
2-year history of numerous raised nonpigmented, closely
spaced skin tags measuring up to 2 mm in diameter
and forming small plaques dorsally on the neck and at
the base of the tail. No alopecia was reported and no
other dermatological or systemic signs were observed.
Case 2 was a 5-year-old male Bulldog that showed
plaque-like lesions similar to those in case 1 on the
Correspondence: Dr Alexandre Bidaut, Institute of Animal
pathology, University of Bern, Laenggassstrasse 122, Postfach, CH3001 Bern, Switzerland. E-mail: alexandre.bidaut@itpa.unibe.ch
2003 European Society of Veterinary Dermatology

back of the head and on the right side of the neck. This
dog had low grade pruritus associated with the lesion.
Case 3 was a 3-year-old male Bulldog that presented
with a raised, plaque-like, exudative lesion on the dorsal
neck with a folded irregular surface. The lesion had
persisted for 1 year. The dog had a concurrent bacterial
pododermatitis.

MATERIALS AND METHODS

Skin biopsies from the lesions of the three dogs were
obtained fixed in 4% neutral buffered formalin. Biopsy
specimens were embedded in paraffin and processed
for routine histopathology. Sections were stained with
haematoxylin and eosin (H&E; all cases), periodic acid
Schiff (PAS), Van Gieson and Alcian blue/PAS at pH 2.5,
staining most mucopolysaccharides (cases 1 and 3). Case
1 was examined at the Institute of Animal Pathology at
Bern (Switzerland), case 2 at Dr Nolis private hospital
(Milan, Italy) and case 3 at Idexx Laboratories (USA).

RESULTS
Light-microscopy examination of the skin sections
revealed plaques composed of numerous superficial
individual to contiguous polypoid masses consisting of
variable amounts of oedema and collagen fibres covered
by a normal to moderately hyperplastic epidermis
(Fig. 1). Using histological examination the polypoid
masses measured 0.22.5 mm in length and up to 1 mm
in width. The core of the polyps varied with mainly
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A. P. Bidaut et al.

Figure 1. Case 2: multiple closely arranged polypoid masses form an

acrochordonous plaque. H&E 15.

oedema in case 1 (Fig. 2a), oedema intermixed with a

moderate amount of collagen fibres in case 2 (Fig. 2b)
and a dense fibrous tissue in case 3 (Fig. 2c). Corresponding to the increasing degree of fibrosis of the
core material, the epidermis covering the polyps was
normal in case 1, mildly to moderately hyperplastic in
case 2 and moderately hyperplastic with the formation of
rete ridges in case 3 (Fig. 2). Within the core and in the
surrounding dermis there were scattered mild infiltrates
of plasma cells, lymphocytes and macrophages in cases
2 and 3. The infiltrate in case 1 was minimal.
No mucinous material was present in the polyps of
cases 1 and 3 as determined by Alcian blue/PAS staining. Adipose tissue and occasional nerve fibres within
the acrochordons, as occasionally seen in humans,3
were not present in the three cases.

DISCUSSION
In animals, single or multifocal concurrently appearing
acrochordons or fibroepithelial polyps are known to
occur rarely.5 They have never been described as

forming plaques. The unique histological features of

the cases presented here, associated with the clinically
visible plaque-like lesion, lead us to propose acrochordonous plaque as a new entity in the dog.
In humans acrochordons are pedunculated masses
consisting of a core of fibrovascular tissue covered by
keratinized stratified squamous epithelium.13 Similar
histological findings are reported in animals.4,5 Interestingly, one of our cases (case 1) had marked oedema
in the polyp core. Oedema and fibrosis correlated negatively in the three cases. Furthermore, the hyperplasia
of the overlying epidermis correlated with the fibrosis.
These histological features might reflect a time-related
modification of the acrochordonous plaque, beginning
as an oedematous lesion and progressing over time to
fibrosis. Conversely, fibrous tissue deposition and
epidermal hyperplasia are common responses of the
skin to repeated irritation and chronic inflammation,
possibly due to persistent trauma. It may, therefore, be
possible that the varying degree of fibrosis seen histologically might reflect differences in the degree of external
irritation such as scratching or rubbing and not be
related to the time they exist.
Various hypotheses for the aetiology of acrochordons
have been put forward in man, including overproduction of epidermal growth factor in association with
skin neoplasms,3 possible association with colonic
polyps2 or association with underlying impaired carbohydrate metabolism.6 In dogs and cats acrochordons
have been proposed to be associated with trauma or
focal resolving furunculosis.4 A traumatic origin of the
lesions in our cases was not determined.
A breed predisposition may be hypothesized
because of the occurrence of this lesion in three brachycephalic dogs. However, the small number of cases
does not allow such a conclusion. As Pug dogs and
Bulldogs have a thicker skin on the neck and at the base
of the tail with a higher content of interstitial fluid
than other dog breeds, it could be proposed that this
particular skin morphology might favour the formation of oedematous polyps which subsequently undergo
fibrosis due to external trauma.

Figure 2. (a) Case 1: single polypoid unit of

an acrochordonous plaque. The core of the
polyp contains lightly eosinophilic oedema
intermixed with rare collagen fibres and
vascular structures. Note the normal
thickness of the overlying epidermis. H&E
25. (b) Case 2: the core of the polyps
contains a minimal to moderate amount of
collagen
fibres
admixed
with
a
corresponding amount of oedema. Note
the mild to moderate hyperplasia and
hyperkeratosis of the overlying epidermis.
There is a mild mixed inflammatory
infiltrate. H&E 100. (c) Case 3: the core of
the polypoid units consists of abundant
dense fibrous tissue. Note the mild to
moderate hyperplasia of the epidermis with
some rete ridge formation and the mild
inflammatory infiltrate. H&E 100.
2003 European Society of Veterinary Dermatology, Veterinary Dermatology, 14, 177179

Acrochordonous plaques in two Bulldogs and a Pug

In summary, we report here a new clinical entity of
numerous closely spaced acrochordons forming a
plaque preferentially located on the dorsal neck of
brachycephalic dogs.

REFERENCES
1. From, L., Assaad, D. Neoplasms, pseudoneoplasms, and
hyperplasia of supporting tissue origin. In: Fitzpatrick,
T.B., Eisen, A.Z., Wolff, K. et al. eds. Fitzpatricks Dermatology in General Medicine, 4th edn. New York: McGrawHill, 1993: 1200 1.
2. Lever, W.F., Schaumburg-Lever, G. Tumors of fibrous tissue.
In: Lever, W.F., Schaumburg-Lever, G. eds. Histopathology
of the Skin, 7th edn. Philadelphia: Lippincott, 1990: 6645.

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3. Murphy, G.F. Neoplasms. In: Murphy, G.F., ed.

Dermatopathology. Philadelphia: W.B. Saunders, 1995:
191.
4. Walder, E.J., Gross, T.L. Neoplastic diseases of the skin.
In: Gross, T.L., Ihrke, P.J., Walder, E.J. eds. Veterinary
Dermatopathology. A Macroscopic and Microscopic Evaluation of Canine and Feline Skin Disease. St. Louis, MO:
Mosby Year Book, 1992: 40910.
5. Goldschmidt, M.H., Dunstan, R.W., Stannard, A.A.
et al. Histological classification of epithelial and melanocytic tumors of the skin. In: WHO International Histological Classification of Tumors of Domestic Animals,
2nd edn. vol. 3. Washington, DC: Armed Forces Institute
of Pathology, 1998: 3792.
6. Demir, S., Demir, Y. Acrochordon and impaired carbohydrate metabolism. Summary. Acta Diabetologica 2002; 39
(2): 579.

Rsum Les acrocordons ou polypes fibropithliaux sont des lsions cutanes pseudo-tumorales, exophytiques
pdoncules, rapportes chez lhomme et lanimal. Nous dcrivons ici a prsentation nouvelle et atypique
dacrocordons nombreux, associs, formant une plaque, localise sur la face dorsale du cou chez deux Bulldog
et un Carlin. Lexamen histopathologique de ces plaques tait caractris par un centre oedmateux fibreux,
entour par un piderme normal ou modrment hyperplasique. Nous proposons le nom de plaque acrocordonneuse qui reflte la lsion clinique et laspect histopathologique. Ltiologie de ces lsions reste peu claire, mais
il pourrait y avoir une prdisposition raciale pour les chiens de type Bulldog.
Resumen Acrocordones o plipos fibroepiteliales son lesions exofticas o pedunculadas de la piel descritas en
humanos y animales. En este artculo se describe una presentacin inusual de numerosos acrocordones, muy cercanos entre s, formando una placa, localizados preferentemente en la parte dorsal del cuello en dos perros de
raza Bulldog y un Pug. Histopatologicamente, estas placas se caracterizaban por columnas centrales de tejido
edematoso fibroso recubiertas de una epidermis normal a moderadamente hiperplsica. Proponemos el nombre
de placa acrocordonosa que refleja la lesin clnica y la apariencia histopatolgica de numerosos acrocordones
muy cercanos entre s. Mientras que la etiologa de estas lesiones no est clara, parece existir una predisposicin
en razas tipo Bulldog.
Zusammenfassung Acrochordone oder fibroepitheliale Polypen sind exophytische bis gestielte tumorhnliche
Hautlsionen von Menschen und Tieren. Hier berichten wir von einer neuen und ungewhnlichen Prsentation
mit zahlreichen, Plaque-bildenden Akrochordonen, die vorzugsweise am dorsalen Nacken zweier Bullterrier und
eines Mopses zu finden waren. Histopathologisch waren diese Plaques durch dematse bis fibrse, von normaler
bis mssig hyperplastischer Epidermis eingeschlossene Kerne gekennzeichnet. Wir schlagen vor, diese Lsionen
akrochordone Plaques zu nennen, um die klinische Lsion und die histopathologisch zahlreichen und nahe beinander liegenden Akrokordone zu bercksichtigen. Die tiologie dieser Lsionen ist unklar, mglicherweise liegt
eine Rasseprdisposition bei Bulldoggen und hnlichen Hunden vor.

2003 European Society of Veterinary Dermatology, Veterinary Dermatology, 14, 177179