Pyogenic granuloma

Pyogenic granuloma (PG) is an acquired vascular lesion of the skin and mucous membranes common to the pediatric age group. PG appears as a solitary red nodule on the head or neck. The nodule is prone to hemorrhage, and bleeding is often refractory to pressure. The etiology of PG is unknown, but proposed agents include trauma, infection, and preceding dermatoses. Several surgical treatments are available with variable cosmetic results and recurrence rates.     

Pyogenic granuloma in children

Pyogenic granuloma, also known as lobular capillary hemangioma, is a common, benign, acquired, vascular neoplasm of the skin and mucous membranes characterized by an erythematous, dome-shaped papule that bleeds easily. This is a retrospective study of 128 children with pyogenic granuloma treated at the Johns Hopkins pediatric dermatology clinic between 1991 and 2001. This study was undertaken to analyze the clinical characteristics, natural history, treatment options, recurrence risk, and outcome of this entity in children. The majority of the patients had uncomplicated pyogenic granuloma and were treated with a single shave excision and electrocautery, with no recurrences and good cosmetic results.     

Pyogenic granuloma of the penis--don't squeeze them

We report the case of a pyogenic granuloma on the shaft of the penis presenting with active bleeding secondary to attempted expression. Previously reported cases have documented such lesions on the prepuce and glans.     

Pyogenic granuloma arising within a port-wine stain

Pyogenic granulomas are common overgrowths of vascular tissue that usually arise on the face, lips, or hands after episodes of minor trauma or during pregnancy. Pyogenic granulomas rarely have been reported to arise in congenital capillary malformations such as port-wine stains, a presentation that most often occurs after laser treatment of port-wine stains or in the setting of pregnancy. This co-occurrence of the 2 lesions represents an underreported event, and the presentation can be alarming or mimic malignancy when there is no prior history of trauma or other known circumstances in which pyogenic granulomas occur. We report a case of a pyogenic granuloma emerging within a port-wine stain in a 35-year-old man with no predisposing factors. A review of the literature regarding pyogenic granulomas that arise within port-wine stains is presented and yields informative conclusions regarding the clinical scenarios where this sometimes alarming event is likely to happen.     

Pyogenic granuloma following the trauma of noseboring

The occurrence of pyogenic granuloma following nose-boring for the wearing of ornaments is recorded. Boring of the nose is seen in 60--70% of women in our skin out-patient department and pyogenic granuloma occurs in 33% of such women. The condition is not encountered after boring of the ear lobes, and this suggests that the tissues of the alae nasi are abnormally susceptible to this reaction.     

Pyogenic granuloma, port-wine stain and pregnancy

We present a novel case of pyogenic granuloma occurring within a port-wine stain in two sequential pregnancies at different sites. There was no history of precipitating events such as trauma. We discuss why a pyogenic granuloma may occur within a port-wine stain and how pregnancy may increase the likelihood of this occurring.     

Pyogenic granuloma of the penile shaft following circumcision

Pyogenic granuloma is a benign vascular, inflammatory proliferation that appears following minor trauma in children. The exact pathogenesis of pyogenic granuloma is unknown, but its formation is closely related to minor trauma, chronic irritation, and hormonal influences. We present a unique case of a pyogenic granuloma that appeared in an infant following circumcision.     

Pyogenic granuloma arising in port-wine stain after cryotherapy

Pyogenic granuloma is a reactive vascular tumor that rarely arises in association with port-wine stain, either spontaneously or after trauma. A 21-year-old woman, presented here, developed a pyogenic granuloma within a facial port-wine stain after treatment with cryotherapy.     

Pyogenic granuloma of the penis--a rare entity?

A case of pyogenic granuloma of the prepuce is presented. This to our knowledge, is the first reported case of this condition affecting this site.     

Pyogenic granuloma following laser treatment of a port-wine stain

A pyogenic granuloma occurred in a port-wine stain treated with first an argon, and subsequently a carbon dioxide, laser. Although reports of this phenomenon are infrequent in the literature, our review suggests that this is not a rare complication. The pathogenetic implications are discussed.     

Pyogenic granuloma complicating pulsed-dye laser therapy for cherry angioma

A 37 year-old-woman presented for cosmetic removal of a 7-mm (diameter) cherry angioma on her right anterior thigh. Various treatment options were discussed and removal of the lesion using pulsed-dye laser was carried out. The patient returned 5 weeks later complaining of bleeding from the treatment site, which on examination showed a 23 × 23-mm friable nodular lesion with the typical appearance of a pyogenic granuloma. This lesion was removed by shave excision, curettage and electrodessication. Histopathological examination confirmed the diagnosis of pyogenic granuloma. This is a rare occurrence post pulsed-dye laser therapy that physicians may choose to discuss with patients prior to performing this procedure.