True or False: If removing an unusual or inflamed skin tag, send to pathology?

• A. False
• B. True
• C. Not sure
• D. It depends

Answer: (B)

When a lesion that looks like a skin tag is unusual or inflamed, sending it to pathology is the prudent step. Skin tags are usually benign, but inflammation, atypical features, or rapid changes can mask other conditions that mimic a skin tag—potentially including premalignant or malignant processes. Histology provides a definitive diagnosis, helps rule out skin cancers or infections, and confirms that the removal is truly benign. If a skin tag appears classic and asymptomatic, pathology isn’t always needed, but inflammatory or atypical presentations warrant examination.