Pyogenic granuloma

Pyogenic granuloma is caused by a small growth of blood vessels. These are not medically concerning, but can be distressing to families because of how easily they bleed. Because of the tendency to bleed, it is usually recommended that pyogenic granulomas be removed.

Symptoms/History

Pyogenic granulomas are common growths of blood vessels that can occur on the skin or mucosa.1 The most common areas of involvement are the trunk and arms.1 They are typically bright red to red-brown, but sometimes can appear black if there has been frequent bleeding due to the development of a scab-like surface. The surface may be smooth or more lobulated (cauliflower-like).1 The size of pyogenic granulomas can be highly variable. They may develop at any age.

Pathogenesis

The reason for development of pyogenic granulomas is unknown. It has been hypothesized that pyogenic granulomas may develop in areas of trauma or may be hormonally mediated.1

Diagnosis

The diagnosis is most often made clinically. When in doubt, a skin biopsy may be performed which can also treat the pyogenic granuloma.

Treatment

One of the most common methods for treatment of small pyogenic granulomas is shave removal followed by curettage (scraping the underlying skin). For larger lesions, surgical excision may be required.2 Very small pyogenic granulomas may be managed with chemical cauterization with silver nitrate or liquid nitrogen; however, these treatment methods have high rates of recurrence.2

References

1. Harris MN et al. “Lobular capillary hemangiomas: An epidemiologic report, with emphasis on cutaneous lesions.” J Am Acad Dermatol 2000; 42(6): 1012-1016.

2. Lee J et al. “Treatment options for cutaneous pyogenic granulomas: A review.” J Plast Reconstr Aesth Surg. 2011; 64(9): 1216-1220.