Author: Vanessa Ngan, Staff Writer, 2003.
Pyogenic granuloma is a relatively common, reactive proliferation of capillary blood vessels. It presents as a shiny red lump with a raspberry-like or minced meat-like surface. Although they are benign, pyogenic granulomas can cause discomfort and profuse bleeding.
Pyogenic granuloma is also called lobular capillary haemangioma, granuloma pyogenicum and granuloma telangiectaticum.
The cause of pyogenic granuloma is unknown. The following factors have been identified as having a possible role in their development.
Pyogenic granuloma affects people of all races. Women are affected more often than men because of the relationship with pregnancy. It rarely occurs in children less than 6 months old but is common in children and young adults.
Pyogenic granuloma usually first appears as a painless red, brownish-red or blue-black spot. It grows rapidly over a period of a few days to weeks to a final size of 1–2 cm (rarely up to 5 cm). It typically bleeds easily and may ulcerate to form a crusted sore. Usually a single lesion is present but in rare cases multiple lesions may develop.
They are most frequently found on the head, neck, upper trunk, hands (especially fingers) and feet. The pregnancy variant of pyogenic granuloma most often occurs on the mucosal surfaces of the lip or inside the mouth.
How is pyogenic granuloma diagnosed?
Pyogenic granuloma is usually diagnosed clinically because of its typical time course and appearance.
Histology confirms the diagnosis, especially if a form of skin cancer such as amelanotic melanoma is in the differential diagnosis. Pyogenic granuloma reveals a lobular collection of blood vessels within inflamed tissue.
Pyogenic granulomas may go away on their own, particularly those associated with pregnancy. If due to a drug, they usually disappear when the drug is stopped.
There are several methods used to remove pyogenic granuloma.
Recurrence after treatment is common because feeding blood vessels extend deep into the dermis in a cone-like manner. In these cases, the most effective method of removal is to completely cut out the affected area (excision), which is then closed with stitches.
Neri I, Baraldi C, Balestri R, Piraccini BM, Patrizi A. Topical 1% propranolol ointment with occlusion in treatment of pyogenic granulomas: An open-label study in 22 children. Pediatr Dermatol. 2017 Dec 20. doi: 10.1111/pde.13372. [Epub ahead of print] PubMed PMID: 29266656. PubMed.
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