From the Guidelines
Achrochordon and DPNs are two distinct conditions, with Achrochordon referring to skin tags and DPNs referring to diabetic peripheral neuropathy, a complication of diabetes that can significantly impact quality of life. When considering the management of DPNs, it is essential to prioritize treatments that improve symptoms, reduce sequelae, and enhance quality of life.
- The most recent and highest quality study, 1, recommends optimizing glucose control to prevent or delay the development of neuropathy in patients with type 1 diabetes and to slow the progression of neuropathy in patients with type 2 diabetes.
- Additionally, assessing and treating patients to reduce pain related to diabetic peripheral neuropathy and symptoms of autonomic neuropathy is crucial, as stated in 1.
- The study also suggests that either pregabalin or duloxetine are recommended as initial pharmacologic treatments for neuropathic pain in diabetes, as indicated in 1. In contrast, Achrochordons (skin tags) are benign skin growths that can be managed through various removal methods, including snipping with scissors, cryotherapy with liquid nitrogen, electrocautery, or ligation with a suture or dental floss.
- It is essential to note that the treatment of Achrochordons is typically performed for cosmetic purposes only, and the underlying cause involves genetic factors and skin friction, with hormonal changes sometimes playing a role in skin tag development.
- Another study, 1, provides guidance on the diagnosis and management of diabetes, including the importance of achieving glycemic control to prevent or delay diabetic peripheral neuropathy. Therefore, the most appropriate approach to managing DPNs is to prioritize treatments that improve symptoms, reduce sequelae, and enhance quality of life, while also optimizing glucose control and considering pharmacologic treatments such as pregabalin or duloxetine, as recommended in 1.
From the Research
Diabetic Peripheral Neuropathy (DPN) and Achrochordon
- There is no direct evidence in the provided studies that links Achrochordon (also known as skin tags) to Diabetic Peripheral Neuropathy (DPN) 2, 3, 4, 5, 6.
- DPN is a common complication of diabetes that affects up to 50% of patients with diabetes mellitus, increasing the risk of diabetic foot ulcers and infections 2.
- The treatment of DPN typically involves addressing underlying risk factors such as poor glycemic control, vitamin B12 deficiency, elevated blood pressure, and obesity, as well as the use of medications like duloxetine, gabapentin, amitriptyline, and pregabalin 2, 3, 4, 5, 6.
Treatment Options for DPN
- First-line drug therapy for painful DPN includes duloxetine, gabapentin, amitriptyline, and pregabalin, although evidence for long-term benefit and safety is lacking 2.
- Second-line drug therapy includes nortriptyline, imipramine, venlafaxine, carbamazepine, oxcarbazepine, topical lidocaine, and topical capsaicin 2.
- Nondrug therapies with low- to moderate-quality evidence include exercise and neuromodulation with spinal cord stimulation or transcutaneous electrical nerve stimulation 2.
Management of Painful DPN
- Painful DPN is often misdiagnosed and inadequately treated, and management remains challenging due to difficulties in personalizing therapy and ascertaining the best dosing strategy 4.
- Duloxetine and pregabalin remain first-line therapy for neuropathic pain in DPN, and their use has been approved by the US Food and Drug Administration 4.
- Pregabalin is a first-line treatment in all major international guidelines on the management of painful DPN, leading to a clinically meaningful improvement in pain scores and offering consistent relief of pain 5.