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A 65-year-old Caucasian male presented with a 6x4x3 cm mass on the scrotal skin. The patient admitted that the lesion had been present for about ten years and it increased in size gradually. The past medical history was unremarkable. Physical examination revealed a hyperpigmented, erythematous, polypoid mass hanging from the left scrotal skin with a peduncle. The lesion was soft and nontender to palpation. In addition, there was a hyperkeratotic, skin colored, small papule on the left scrotum above the giant polypoid mass measuring 2x3x4 mm in size (Fig. 1). The patient stated that the small lesion appeared for about two months ago. Both of the lesions were removed surgically under local anesthesia to reach a definitive diagnosis (Figs. 2a and 2b). Histopathological examination of the polypoid mass and the small papule revealed a skin tag and verruca anogenitalis, respectively.

A giant skin tag of the scrotum and verruca anogenitalis