Pyogenic Granuloma: Causes, Diagnosis, and Treatment

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A pyogenic granuloma is a rapidly growing lesion that bleeds easily. Pyogenic granulomas are 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.

Pyogenic granulomas tend to bleed because they contain a very large number of blood vessels. They’re also known as lobular capillary hemangioma or granuloma telangiectaticum. These legions are benign (noncancerous) and can be safely removed through various methods.

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Causes

A pyogenic granuloma often occurs in areas of previous trauma including acne cysts. It is believed that this lesion is formed when capillaries start growing rapidly in response to trauma to the skin. Other causes of pyogenic granulomas include skin injuries, trauma caused by bug bites, or by scratching your skin roughly or frequently. 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 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 granulomas occur in pregnant women, they often grow on the gums and are called “pregnancy tumors.”

Diagnosis

Your healthcare provider will likely be able to diagnose a pyogenic granuloma based on its appearance. In some cases, they may 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. This procedure may cause bleeding, and it’s important that the blood vessels feeding the lesion at the base are destroyed, or it can recur. In some cases, a pulsed-dye laser can be used to treat small lesions, especially in children.

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.

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