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Pyogenic granuloma is a common benign vascular tumor occurring in all ages. Both skin and mucous membranes can be affected.

Pyogenic granuloma is a 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.

Causes

The cause of pyogenic granuloma is unknown. The following factors have been identified as having a possible role in their development.

  • Trauma: some cases develop at the site of a recent minor injury, such as a pinprick.
  • Infection: Staphylococcus aureus is frequently present in the lesion.
  • Hormonal influences: they occur in up to 5% of pregnancies and are sometimes associated with an oral contraceptive.
  • Drug-induced; multiple lesions sometimes develop in patients on an oral retinoid(acitretin or isotretinoin) or a protease inhibitor.
  • Viral infection is possible but not proven.
Signs and Symptoms

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.

Treatment

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.

  • Surgical excision
  • Curettage and cauterization
  • Laser surgery
  • Cryotherapy
  • Imiquimod cream has been reported to be effective and may be particularly useful in children.
  • Experimentally, topical 1% propranolol ointment has proved effective when used early in children with pyogenic granuloma.

Recurrence after treatment is common.

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