II. Definitions
- Pyogenic Granuloma
- Highly vascular variant of Capillary Hemangioma
III. Epidemiology
- Common lesion in children and young adults
IV. Causes
- Often idiopathic
- Prior Trauma (esp. penetrating injury) or Burn Injury
- Viral Infection
V. Symptoms
- Bleeding from friable lesion
- Occurs with minimal Trauma
- Lesions may also ulcerate
VI. Signs
- Characteristics: Initial
- Characteristics: Later
- Fibrous lesion similar to fibroma
- Distribution
- Head and neck (most common in children and young adults)
- Eyelid (most common acquired Eyelid lesion)
- Gingiva or other mucosal surface
- Occurs in infants, children and young adults
- Pregnant women (Epulis gravidarum)
- Onset in 2% of women in late first trimester, second trimester
- Resolves with delivery
- Trunk and Extremities (most common in adults)
- Finger tips
- Lateral nailfold (periungual)
- Head and neck (most common in children and young adults)
VII. Differential Diagnosis
- Nodular Melanoma or Amelanotic Melanoma
- Spitz Nevus
- Cherry Angioma
- Amelanocytic Nevus
- Squamous Cell Skin Cancer
- Basal Cell Skin Cancer
VIII. Management: Surgical
- Send lesion for pathology due to differential diagnosis
- Surgical excision
- Lowest recurrence rates if completely excised
- Shave excision with electrodesiccation and curretage (or Cryotherapy or laser ablation)
- Mean recurrence rate: 4.5% (up to 15%)
- Recurs if not completely excised or ablated
IX. Management: Medical
- Consider topical Beta Blockers (e.g. Propranolol, Timolol) under Occlusion in children