CV
Pyogenic Granuloma
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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]
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