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Pyogenic Granuloma
Aka: Pyogenic Granuloma, Epulis Gravidarum, Lobular Capillary Hemangioma
- Definition
- Highly vascular variant of Capillary Hemangioma
- Epidemiology
- Common lesion in children and young adults
- Causes
- Often idiopathic
- Prior Trauma (esp. penetrating injury) or Burn Injury
- Viral infection
- Symptoms
- Bleeding from friable lesion
- Occurs with minimal Trauma
- Signs
- Characteristics
- Initial
- Small bright red, purple to yellow dome-shaped Papule
- Grows rapidly into Nodule
- Moist, glistening surface
- Often pedunculated, pulpy vascular lesions
- Surrounded by Scaling collarette
- Later
- Fibrous lesion similar to fibroma
- Distribution
- Head and neck
- Eyelid (most common acquired Eyelid lesion)
- Extremities
- Finger tips
- Lateral nailfold (periungual)
- 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 and resolves with delivery
- Differential Diagnosis
- Nodular Melanoma
- Elmets (1980) Cutis 25:164-8 [PubMed]
- Spitz Nevus
- Amelanocytic Nevus
- Squamous Cell Skin Cancer
- Basal Cell Skin Cancer
- Management
- Shave excision with electrodesiccation and curretage (or laser ablation)
- Send lesion for pathology due to differential diagnosis
- Recurs if not completely excised
- References
- Habif (1996) Dermatology, Mosby-Year, p. 732
- Higgins (2015) Am Fam Physician 92(7): 601-7 [PubMed]
- Luba (2003) Am Fam Physician 67(4):729-38 [PubMed]