- Relatively common skin growth that presents as a shiny red mass with friable surface, grows rapidly over weeks to months .The size rarely exceeds one centimeter.
- Benign (non-cancerous), may cause problems of discomfort and profuse bleeding and may become ulcerated.
- Pyogenic granulomas are usually solitary, but multiple satellite lesions and disseminated forms also occur.
Atielogy is unknown. Possible trigger factors include:
- Trauma- site of minor injury.
- Infection: frequently Staphylococcus aureus
- Hormonal (pregnancies)
- Drug-induced; systemic retinoids (acitretin or isotretinoin) or protease inhibitors
- Viral infection is possible but not proven
- Underlying microscopic blood vessel malformations
Treatment
Treatment is usually due to frequent ulceration and bleeding. There is no consensus regarding optimal treatment.
Remove any underlying cause ie causative drug
Pyogenic granulomas in other cases tend to persist, it rarely resolves spontaneously. Treatment involves physical
removal of lesion. Cryotherapy, topical and intralesional injection are generally not recommended due to recurrences rate.
- Curettage and cauterisation : the lesion is scraped off with a curette and the feeding blood vessel cauterised to reduce the chances of re-growth
- Laser surgery can be used to remove the lesion and burn the base, or a pulse dye laser may be used to shrink small lesions
- Surgical excision: the most effective method of removal
- Cryotherapy may be suitable for small lesions
- Chemical cauterisation using silver nitrate
- Topical Imiquimod (may be particularly useful in children)
- Topical phenol
- Topical beta blocker (ie topical timolol)
- Injectable sclerosing agent
- Intralesional injection (i.e bleomycin, cortisosteroid)
Recurrence after treatment is common because feeding blood vessels extend deep into the dermis.
References
1. DermNet NZ
2. Up-To-Date
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