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 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 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 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 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 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 over the venous component of a mixed vascular malformation

A 52‐year‐old man presented with a rapidly growing red tumor on the central neckline. It had appeared over a congenital flat and pinkish vascular lesion that involved the shoulder and the upper anterior area of his chest. Intermingled with the pinkish stain, there were also some blue nodules several millimeters in diameter. Histopathologic examination revealed that the full lesion was a mixed venous‐capillary malformation. The red tumor was excised and diagnosed as a pyogenic granuloma developing over the venous component of the vascular malformation. To our knowledge, a pyogenic granuloma growing over a venous malformation has not been previously described.     

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 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 in children: treatment with topical imiquimod

We report the successful treatment of five children with facial pyogenic granuloma using topical imiquimod 5% cream. In all cases, resolution of the lesions was achieved within 2-4 weeks. Local erythema and scaling, consistent with a typical imiquimod response, was the most commonly observed side effect. No systemic complications were observed in any of the patients. There has been no recurrence of any of the lesions to date. Small mildly erythematous or hypopigmented macules remain at this stage of follow up.     

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.