Pyogenic Granuloma

Key Points
Common skin condition typically affecting the upper torso, hands, feet, head or neck
Exact cause is unknown, but may develop in relation to several factors
Consists of a solitary red, red/brown or black growth which grows rapidly and may be accompanied by crusting and severe bleeding

Pyogenic granuloma is a common, benign skin condition which typically affects the upper torso, hands, feet, head or neck. The condition typically consists of a solitary red, red/brown or black growth which grows rapidly and may be accompanied by recurrent bleeding. Growths may ulcerate and form sores which are crusted, and can grow up to 5 cm in size. Rarely, multiple growths may appear. In pregnant women, growths often develop on the interior of the mouth.

The cause of Pyogenic granuloma is unknown, though its development may be related to several varying factors, including trauma or infection in the affected area, hormones, Drug reactions, or even malformation of blood vessels. Women are more commonly affected due to changes in hormone levels during pregnancy, though anyone may develop the condition.

Differential Diagnosis (Other conditions with similar appearance)
Amelanotic Malignant Melanoma
Angiolymphoid hyperplasia with eosinophilia
Bacillary angiomatosis
Basal cell carcinoma
Benign lymphangioendothelioma
Eruptive epithelioid hemangioendothelioma with spindle cells
Glomeruloid Hemangioma
Glomus tumor
Kaposi sarcoma
Metastatic carcinoma
Microvenular Hemangioma
Squamous cell carcinoma
Tufted Hemangioma

Diagnosis
Key Points
Diagnosis based on appearance of the affected area
Skin biopsy will be performed to confirm diagnosis and rule out other conditions

Pyogenic granuloma is typically diagnosed based on the appearance of the affected area. A skin biopsy will be performed to confirm the diagnosis and to rule out similar appearing conditions.

Treatment
Whether treatment is required is predicated on the cause of the condition
Where treatment is required, removal of lesions is typical
Lesions may recur after therapy

In cases affecting pregnant women, lesions may resolve spontaneously after delivery. Pyogenic granuloma caused by a drug reaction typically resolves once the offending medication is stopped. When other causes are involved, lesions are often persistent, and treatment generally consists of removal. Methods of removal include curettage and cautery, laser therapies, cryotherapy, chemical cautery, and Imiquimod. Lesions often recur after treatment, and surgical excision may be the most effective option to prevent recurrence.