Infantile multiple large pyogenic granuloma on burned skin. Case report and review of literature

Abstract

Pyogenic granuloma (PG) is a benign vascular lesion of the skin and mucous membranes, presenting as a solitary, red, pedunculated papule that bleeds easily and which appears to be a reactive vascular proliferation to minor injury. These lesions are more common in children and are mostly seen in exposed sites. Multiple disseminated PG is a rare condition. This report describes an infant with multiple, disseminated, pyogenic granulomas following burns from boiling milk. We reviewed literature published in English and found 9 cases. Six cases were provoked by hot milk, 2 by hot water, while the cause of the other case is unknown. Angiogiogenetic activity in milk may explain PG development in these patients.

Multiple disseminated pyogenic granuloma post oil burning-review literature

“…PG develops over the burned area between 1 and 4 weeks following burns and may be infected with bacteria and fungi.As in other cases in the literature in English, there were 25 cases of disseminated PG following burn from 1978 to 2020. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] The cases occurred approximately between 1 and 4 weeks following burning mostly secondary to milk (nine cases), nine cases of scald burn, one case provoked by hot water, and four thermal burns or flames and two cases are not mentioned. Surprisingly, in our patient, the etiology was oil.…”

“…We also reviewed the literature and found 25 other cases that mostly caused by milk burning. [4,[5][6][7][8][9][10][11][12][13][14][15][16][17][18] Case Report A 30-year-old woman was referred to our department ( Al Zahra Hospital; Referral Center for Treatment of Skin Diseases). The patient had 60% body surface third-degree burn due to oil 4 weeks before.She was treated using daily dressing with silver sulfadiazine and intravenous antibiotic in a burn care center (Imam Musa Kazim hospital), and the burned skin in her thigh was successfully repaired with full-thickness skin graft from the left forearm origin.During this period, 24 days after the burn injury, multiple papillomatoses and nodular lesions appeared periphery of the burn site and also around the donor site on her forearm [ Figure 1].…”

Pyogenic granuloma over the venous component of a mixed vascular malformation

“…Other less frequently reported locations are the subcutis and inside large veins . It usually appears in isolation, although cases of multiple pyogenic granulomas have been described, especially with recurrences after treatment, as satellite lesions . Pyogenic granulomas have been described in association with mild chronic irritation, previous trauma, insect bites, burns including scalds and cryotherapy, immobilization with plaster, peripheral nerve damage, or different treatments such as antineoplastics, granulocyte colony‐stimulating factors, antiretrovirals, immunosuppressants, retinoids, and epidermal growth factor receptor or rapidly accelerated fibrosarcoma kinase B inhibitors .…”

“…5,6 It usually appears in isolation, although cases of multiple pyogenic granulomas have been described, 7-10 especially with recurrences after treatment, as satellite lesions. 11 Pyogenic granulomas have been described in association with mild chronic irritation, previous trauma, insect bites, burns including scalds 10 immunosuppressants, retinoids, and epidermal growth factor receptor or rapidly accelerated fibrosarcoma kinase B inhibitors. 12 In many cases, a trigger cannot be identified.…”

Nonepithelial Tumors and Tumor-like Lesions of the Skin and Subcutis in Children

“…Multiple disseminated LCH-PGs have been reported following severe burns. 10,11 An uncommon manifestation of recurrent LCH-PG is the development of multiple satellite lesions (Warner and Wilson-Jones syndrome). 12 Another presentation of LCH in children is a tumor arising in the subcutaneous tissues which accounts for almost 4% to 5% of cases.…”