Pyogenic Granuloma

Pyogenic Granuloma: Diagnosis and Treatment

A pyogenic granuloma is a rapidly growing lesion that bleeds easily. This lesion is common in children and young adults, although they can develop in people of all ages.  They are also fairly common in pregnant women. The hormone changes that occur during pregnancy can cause these growths to develop.

They tend to bleed because they contain a very large number of blood vessels. They’re also known as lobular capillary hemangioma, or granuloma telangiectaticum.

They’re benign (noncancerous) and can be safely removed through various methods.

Causes

A pyogenic granuloma often occurs in areas of previous trauma including acne cysts. It is believed that this lesion is formed when capillary blood vessels start growing rapidly in response to trauma to the skin.

These growths mostly occur after injuries, but the reason for this isn’t known. Other causes of pyogenic granulomas include trauma caused by bug bites or by scratching your skin roughly or frequently. The hormone changes your body goes through when you’re pregnant can also cause pyogenic granulomas. Certain medications can also cause this condition, such as

  • indinavir sulfate (Crixivan)
  • isotretinoin (Accutane)
  • acitretin (Soriatane)
  • some birth control pills

Appearance

A typical pyogenic granuloma is a solitary red papule that grows rapidly over several weeks. It is typically less than 1 cm and has a glistening, moist surface.

It becomes a raised, reddish nodule that’s typically smaller than 2 centimeters. The growth you have can appear smooth, or it might have a crusty or rough surface, particularly if it bleeds a lot. The base of the lesion is often red and scaly. Pyogenic granulomas occur most commonly on the head, neck, arms and fingers.

They can also grow on the lips, eyelids, back and genitals.

In rare cases, they can grow on the conjunctiva or cornea in your eye. The conjunctiva is the clear tissue over the white area of your eye. The cornea is the clear covering over your pupil and iris.

When they occur in pregnant women, they often grow on the gums and are called “pregnancy tumors.”

Diagnosis

Your doctor will likely be able to diagnose a pyogenic granuloma based on its appearance. Your doctor might do a biopsy, which involves taking a tissue sample, for a more accurate diagnosis. A biopsy also helps rule out malignant, or cancerous, medical conditions that can cause a similar kind of growth, such as squamous cell carcinoma, basal cell carcinoma, and melanoma.

Treatment

A pyogenic granuloma is often removed by shaving it off and cauterizing the base with electrosurgery. It often bleeds copiously during removal. It is important that the blood vessels feeding the lesion at the base are destroyed or it can recur. In some cases, pulsed-dye laser can be used to treat small lesions, especially in children.

Pyogenic granulomas can also grow back after being removed. Pyogenic granulomas grow back in up to half of all cases, especially in young adults who have them in the upper back area. In rare cases, several lesions can appear in the area where the pyogenic granuloma was removed. If the granuloma isn’t removed completely, the remaining parts can spread to your blood vessels in the same area.

Continue Reading