A 23-year-old African-American woman presents to the dermatology office with a growth on the right side of her groin area (see Figure 1). She claims that the lesion first appeared many years ago as a small, fleshy tag but that it has enlarged rapidly over the past several years. She reports only minimal irritation but expresses significant concern over its enlarged size. The patient is in good health with no history of a serious skin condition, malignancy, or underlying systemic illness.
Physical examination reveals a 5.535-cm fleshy, skin-toned, pedunculated, baglike tumor on her right inguinal area. The patient otherwise is a well-appearing, albeit overweight, African-American woman. There is no tenderness on palpation of the groin, and she has no signs of infection.
The most likely diagnosis is
• A lipoma
• An acrochordon or skin tag
• A cutaneous neurofibroma
• A keloid