Chicken Skin Mucosa

Does the White Deposit (Chicken Skin Sign) Around the Base of the Polyps Have Any Prognostic Value?

“Chicken skin” mucosa (or “goose skin” in German-speaking countries, or “fish skin” in the Mediterranean and some Far East countries) was first described in Western countries in1998 by Shatz et al. (Am J Gastroenterol).

The authors found that CSM was associated frequently with adenomatous polyps and adenocarcinoma. Histologically, CSM is caused by an accumulation of lipid-laden macrophages. Subsequently, Nowicki et al (J Ped Gastroenterol Nutr, 2005) found that CSM is found in up to 75% of juvenile polyps. By using CD68 stain, which is specific for macrophages, the authors confirmed that CSM is due to lipid-laden macrophages and not associated with increased malignancy.

We had learned from Prof. Parra-Blanco that the first description of CSM was by Prof. Muto from Japan.

Prof. Parra-Blanco: “… this was described as “white spots” (hakuhan in Japanese) by Prof Tetsuichiro Muto in 1981 . But the name “chicken skin mucosa” is more popular in Western countries. It was described in Japanese, but this is the abstract in English.”

  1. Shatz BA, et al. Colonic chicken skin mucosa: an endoscopic and histological abnormality adjacent to colonic neoplasms. Am J Gastroenterol 1998;93:623–7.

  2. Nowicki, M et al. Colonic Chicken-Skin Mucosa in Children with Polyps is not a Preneoplastic Lesion, Journal of Pediatric Gastroenterology and Nutrition. 2005;41:600-606.