Dear Editor, Skin tags/acrochorda are very common fibrous skin lesions that are usually skin-colored, have a folded surface and often a stalk, and range in size from several millimeters to, rarely, many centimeters. 1 Herein, we report a pregnant 32-year-old woman (gravida four, para three) at the 32nd week of gestation and who had a giant skin tag on the left labium majus which grew rapidly during pregnancy.The patient presented at the outpatient clinic due to a soft, bleeding, pedunculated mass (17 cm 9 10 cm 9 4 cm) over the left labium majus that had appeared 20 months previously ( Fig. 1). It had grown rapidly during her pregnancy. Her systemic examination and hematological laboratory tests were normal. An excisional biopsy was taken. Histopathological examination revealed large and small vessels on the subepithelial stroma of the polyp covered with surface-stratified squamous epithelium.The most frequent locations of skin tags are the neck and the axillae, but any skin fold, including the groin and submammary regions, may be affected. Less commonly, they can appear on the penis or labium majus. 2,3 The only differential diagnoses are a flesh-colored dermal nevus and neurofibromatosis. Unless irritated or infarcted, skin tags are more of a cosmetic issue than a clinical concern and can easily be removed by excision, electrodessication or cryosurgery. 1 Skin tags are suggested to be associated with obesity, some endocrine diseases, diabetes mellitus, insulin resistance, genetic predisposition, carbohydrate and lipid metabolism disorders. Pregnancy is also a risk factor. Hormonal changes may affect the development of the acrochordon. Pregnancy hormones can suddenly affect blood vessel tone. During pregnancy, the small blood vessels and capillaries multiply, and most blood vessels enlarge to accommodate a larger blood volume. Therefore, the observed changes are related to this effect. For instance, relaxin 2 is a polypeptide hormone structurally related to insulin and insulin-like growth factors. The characteristic functions of relaxin are associated with the female reproductive system, especially during pregnancy. Recent studies have shown that polypeptides of the relaxin-like factor family are involved in cell proliferation, differentiation and angiogenesis. 4 Furthermore, vascular endothelial growth factor (VEGF) is a molecule involved in the physiology and pathophysiology of pregnancy. VEGF belongs to a family of growth factors controlling angiogenesis and endothelial cell permeability. 5 There are a few case reports of giant skin tags on the labium majus. 2,3 Canalizo et al. 2 reported two cases with giant skin tags on the labium major. Ghosh et al. 3 reported a case series of four patients with giant skin tags, one of whom was a 28-year-old pregnant woman with a pedunculated mass measuring 3 cm 9 2.5 cm in her left nipple which was present for 6 years but grew rapidly during pregnancy.To the best of our knowledge, there are few reports of this condition with lesions of the size reported here 3 and there h...