Pyogenic Granuloma Flashcards
What is it?
Lobular capillary angioma, “shiny red mass”
Causes:
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 rarely associated with oral contraceptives.
Drug-induced; multiple lesions sometimes develop in patients on systemic retinoids (acitretin or isotretinoin) or protease inhibitors
Viral infection is possible but not proven
Underlying microscopic blood vessel malformations
(Dermnetnz)
Treatment
Pyogenic granulomas in pregnant women may go away on their own after delivery so waiting is the best strategy in these cases. If due to a drug, they usually disappear when the drug is stopped.
Pyogenic granulomas in other cases tend to persist. There are several methods used to remove them.
Curettage and cauterisation: the lesion is scraped off with a curette and the feeding blood vessel cauterised to reduce the chances of re-growth
Laser surgery can be used to remove the lesion and burn the base, or a pulse dye laser may be used to shrink small lesions
Cryotherapy may be suitable for small lesions
Chemical cauterisation using silver nitrate is convenient
Imiquimod has been reported to be effective and may be particularly useful in children
Recurrence after treatment is common because feeding blood vessels extend deep into the derm
