Pendulous fibroids: what are they and how do they appear?

By Cristiano Antonino On May 16, 2023

Pendulous fibroids – also known as ‘acrochordons’ or ‘leeks’ – are pedunculated skin growths that originate from the dermis – the layer that lies beneath the epidermis – and that, as they grow, extend outwards

Pendulous fibroids appear to the eye as small outgrowths but, in some fortunately rarer cases, they can also grow to a larger diameter, being particularly annoying and/or unsightly for the patient.

Especially in the latter case, when the fibroma tends to enlarge, gravity pulls it downwards, giving it the name for which they are known: ‘pendulous’.

As ‘fibroids’ they also represent a tumourous form – albeit benign – and only rarely can they evolve into malignant neoplasms.

Pendulous fibroids can appear in any part of the body although, in general, more frequent are the formations in the armpits, neck, groin and upper eyelids, which – not by chance – are also the areas subjected to the most stress and rubbing.

For the same reason, those who are more susceptible – compared to normal-weight people – are those who are clearly obese, which causes more rubbing in rather sensitive areas of the body.

From an age point of view, pendulous fibroids appear in people generally from the age of 40 to 50 years, and are very rare in children and young people.

Pendulous fibroids: symptoms

As already mentioned, pendulous fibroids are a benign form of skin cancer that does not cause any particular type of symptomatology.

Only in some cases, when the formations become large, they may increase in size and create irritation or bleeding in the affected area.

If the irritation persists or the rubbing is excessive and prolonged, it is not uncommon to witness the autonomous detachment – partial or total – of the pendulous fibroma.

This, as it detaches, leaves an open, bleeding wound that, if not carefully treated, could lead to infection.

When the discomfort becomes difficult to manage, surgical removal is considered

The removal of pendulous fibroids is also considered if the formations are aesthetically disfiguring.

The appearance of pendulous fibroids generally has pigmentation identical to that of the surrounding skin (normal-pigmented pendulous fibroids), only in rare situations do they have darker pigmentation.

Pendulous fibroids: what are the causes and who suffers from them?

Apart from the aforementioned skin friction, there are still little known causes of the formation of pendulous fibroids – just like many other benign skin conditions.

As is to be expected, genetics plays a key role in these cases: those who generally have numerous pendulous fibroids have a family history of these formations.

Given their substantial benignity, no major research funds have been invested in research, which is why the aetiology of pendulous fibroids is still largely unknown.

It is only hypothesised – but with an objective reality check – that their formation is due (also) to hormonal alterations occurring in individuals in the 40-50 age bracket.

This, especially in female individuals, who precisely during that period of life experience the physical and hormonal changes due to the menopause.

Diagnosis of pendulous fibroids

The specialist doctor to whom one must turn from the moment one suspects having pendulous fibroids on the body is the dermatologist.

During the examination, the dermatologist will first carry out a thorough anamnesis, checking the patient’s family history to find out if there is any familiarity.

It will be important to inform the dermatologist if there are any ongoing concomitant diseases or regular medication intake.

Subsequently, the dermatologist proceeds with the specialist examination and the possible request for further targeted clinical tests.

The treatment of pendulous fibroids

The only viable therapy is surgical removal, which is strongly recommended by the dermatologist, especially in the presence of particularly exposed pendulous fibroids.

Depending on the area and sensitivity, the dermatologist will opt for traditional removal or removal by laser treatment.

The operation carried out in the traditional manner is in itself simple and fast, and is performed on an outpatient basis with a light local anaesthetic, so that the removal does not cause the patient any pain.

The pendulous fibroma is clamped with forceps and ‘torn’ upwards with a special surgical scalpel.

Several pendulous fibroid tumours can also be removed during the same session.

The operation using the laser instrument enables the complete removal of the pendulous fibroid, while also partially affecting the surrounding skin.

The post-operative course is quick, and healing occurs immediately without leaving any traces or unsightly scars.