Dermatology Book


Pyogenic Granuloma

Aka: Pyogenic Granuloma, Epulis Gravidarum, Lobular Capillary Hemangioma
  1. Definition
    1. Highly vascular variant of Capillary Hemangioma
  2. Epidemiology
    1. Common lesion in children and young adults
  3. Causes
    1. Often idiopathic
    2. Prior Trauma (esp. penetrating injury) or Burn Injury
    3. Viral Infection
  4. Symptoms
    1. Bleeding from friable lesion
      1. Occurs with minimal Trauma
  5. Signs
    1. Characteristics
      1. Initial
        1. Small bright red, purple to yellow dome-shaped Papule
        2. Grows rapidly into Nodule
        3. Moist, glistening surface
        4. Often pedunculated, pulpy vascular lesions
        5. Surrounded by Scaling collarette
      2. Later
        1. Fibrous lesion similar to fibroma
    2. Distribution
      1. Head and neck
      2. Eyelid (most common acquired Eyelid lesion)
      3. Extremities
        1. Finger tips
        2. Lateral nailfold (periungual)
      4. Gingiva or other mucosal surface
        1. Occurs in infants, children and young adults
        2. Pregnant women (Epulis gravidarum)
          1. Onset in 2% of women in late first trimester, second trimester and resolves with delivery
  6. Differential Diagnosis
    1. Nodular Melanoma
      1. Elmets (1980) Cutis 25:164-8 [PubMed]
    2. Spitz Nevus
    3. Amelanocytic Nevus
    4. Squamous Cell Skin Cancer
    5. Basal Cell Skin Cancer
  7. Management
    1. Shave excision with electrodesiccation and curretage (or laser ablation)
    2. Send lesion for pathology due to differential diagnosis
    3. Recurs if not completely excised
  8. References
    1. Habif (1996) Dermatology, Mosby-Year, p. 732
    2. Higgins (2015) Am Fam Physician 92(7): 601-7 [PubMed]
    3. Luba (2003) Am Fam Physician 67(4):729-38 [PubMed]

Pyogenic granuloma (C0085653)

Definition (NCI) A friable, benign vascular neoplasm with lobular capillary architecture that presents as a raised red skin growth.(NICHD)
Definition (NCI) A granuloma caused by infectious organisms and characterized by the presence of abscess formation.
Definition (MSH) A disorder of the skin, the oral mucosa, and the gingiva, that usually presents as a solitary polypoid capillary hemangioma often resulting from trauma. It is manifested as an inflammatory response with similar characteristics to those of a granuloma.
Concepts Disease or Syndrome (T047)
MSH D017789
ICD10 L98.0
SnomedCT 17372009, 395604005, 156323008, 267838007, 200720006, 200725001, 200722003, 39629007
English Granuloma Pyogenicum, Granuloma, Pyogenic, Granuloma Telangiecticum, Hemangioma, Lobular Capillary, Capillary Hemangioma, Lobular, Lobular Capillary Hemangioma, PYOGENIC GRANULOMA, Pyogenic granuloma NOS, Pyogenic granuloma unspecified, Lobular Hemangioma, Granuloma, Pyogenic [Disease/Finding], pyogenic granuloma, lobular capillary hemangioma, granulomas pyogenic, granuloma pyogenicum, capillary lobular hemangioma, granuloma pyogenic, Lobular capillary hemangioma, Lobular capillary haemangioma, Capillary haemangioma of granulation tissue type, Capillary hemangioma of granulation tissue type, Pyogenic granuloma NOS (disorder), Pyogenic granuloma unspecified (disorder), Granuloma telangiectaticum, Granuloma pyogenicum, PG - Pyogenic granuloma, Granuloma pyogenicum (morphologic abnormality), Pyogenic granuloma (disorder), Pyogenic granuloma, granuloma; pyogenic, granuloma; suppurative, granuloma; telangiectaticum, pyogenic; granuloma, suppurative; granuloma, telangiectaticum; granuloma, Granulomatous polyp, Pyogenic Granuloma, Granulation Tissue-Type Hemangioma, Granulomata Pyogenicum, Hemangiomatous Granulation Tissue, Suppurative Granuloma, Granuloma, telangiectaticum, Granuloma, suppurative
French GRANULOME PYOGENE, Hémangiome capillaire lobulaire, Botryomycome, Botriomycome, Granulome pyogénique, Granulome télangiectasique
Portuguese GRANULOMA PIOGENICO, Granuloma Telangiectásico, Granuloma piogénico, Granuloma Piogênico, Hemangioma Lobular Capilar
Swedish Granulom, varbildande
Japanese カノウセイニクゲシュ, 血管腫-小葉毛細血管性, 毛細血管拡張性肉芽腫, 血管拡張性肉芽腫, 血管肉芽腫, 肉芽腫-血管, ボトリオミコーゼ, ボトリオミセス症, 血管腫性肉芽腫, 肉芽腫-血管拡張性, 小葉毛細血管性血管腫, 感染性肉芽腫, 肉芽腫性ポリープ, 化膿性肉芽腫, 肉芽腫-化膿性
Czech granulom telangiektatický, granulom pyogenní, Hnisavý granulom
Finnish Pyogeeninen granulooma
German Granuloma pediculatum [Granuloma pyogenicum], Granulom pyogen, Granulom, pyogenes, Granuloma telangiectaticum, Hämangiom, lobuläres kapilläres
Italian Emangioma lobulare capillare, Granuloma telangectasico, Granuloma piogenico, Granuloma piogeno
Korean 화농성 육아종
Polish Ziarniniak ropotwórczy
Hungarian Pyogen granuloma
Spanish granuloma piogénico, granuloma piogénico, SAI (trastorno), granuloma piogénico, no especificado (trastorno), granuloma piogénico, SAI, granuloma piogénico, no especificado, granuloma piógeno (anomalía morfológica), granuloma piógeno (trastorno), granuloma piógeno, granuloma telangiectásico, Granuloma piógeno, Granuloma Piogénico, Granuloma Telangiecticum, Hemangioma Capilar Lobular
Norwegian Pyogent granulom, Lobulært kapillært hemangiom, Granulom, pyogent, Pyogene granulomer
Dutch granuloom; pyogeen, granuloom; suppuratief, granuloom; telangiectaticum, pyogeen; granuloom, suppuratief; granuloom, telangiectaticum; granuloom, pyogeen granuloom, Granuloma teleangiectaticum, Granuloom, pyogeen, Hemangioom, lobulair capillair, Pyogeen granuloom
Derived from the NIH UMLS (Unified Medical Language System)

Gingival pregnancy tumor (C0472839)

Concepts Disease or Syndrome (T047)
SnomedCT 235003004
English Gingival pregnancy tumor, Gingival pregnancy tumour, Pregnancy epulis, Gingival pregnancy tumor (disorder)
Spanish tumor gingival del embarazo (trastorno), tumor gingival del embarazo, épulis del embarazo
Derived from the NIH UMLS (Unified Medical Language System)

Multiple Lobular Capillary Hemangiomas (C1334826)

Definition (NCI) A lobular hemangioma present in multiple anatomical sites.
Concepts Neoplastic Process (T191)
English Multiple Lobular Capillary Hemangiomas, Multiple Pyogenic Granulomas
Derived from the NIH UMLS (Unified Medical Language System)

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