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However, I have to say the second photo also looks like it contains a sentinel skin tag. The sentinel skin tag appears to be that lump of skin sticking up straight and is not to be confused with an external hemorrhoid, though it might yet be one to a more trained eye. Sentinel skin tags grow when the anus has been hurt or a disease is or has been involved. The key to identifying a hemorrhoid is to look and see if it looks like there is blood inside it causing swelling, like a fluid-filled balloon ( Dr. Koch, editor, Colonic Diseases, Human Press, N.