Pyogenic Granuloma

Abstract

Pyogenic granuloma, also known as lobular capillary hemangioma, is a common, acquired, benign vascular proliferation that typically develops as a small erythematous papule on the skin or oral mucosal surface. The papule usually enlarges quickly to a few millimeters over weeks and growth stabilizes over several months. Clinically, pyogenic granuloma presents as a soft dome-shaped papule/nodule or a sessile or pedunculated papule/nodule with a smooth, glistening, erosive, or friable surface. The color is usually bright red to dusky red. Characteristically, the lesion is asymptomatic and painless. Pyogenic granuloma is usually solitary. Cutaneous pyogenic granulomas are commonly located on the head and neck, as well as fingers and toes. In the oral cavity, pyogenic granulomas are more frequent on the gingiva. The lesion tends to bleed and ulcerate even with very minor trauma which brings patients to seek medical care. Although pyogenic granulomas occur in patients of any age, they are more prevalent in children, adolescents, and pregnant women. Cutaneous pyogenic granulomas have no gender predilection whereas the oral mucosal ones have a female to male ratio of 2:1. Trauma and female sex hormones are possible etiologic factors. The diagnosis is usually clinical. Pyogenic granulomas developing during pregnancy tend to resolve on their own after delivery and usually require no treatment. Most other lesions are treated. Surgical excision with linear closure allows histologic examination of the tissue. It also has the lowest rate of recurrence and is therefore the treatment of choice.

Excision of oral pyogenic granuloma in a diabetic patient with 940nm diode laser

“…Pyogenic granuloma (PG), also known as lobular capillary hemangioma, is a common, acquired, benign vascular proliferation of the skin and mucous membrane. 1 Oral PG is a common, tumor-like, exaggerated tissue response to a localized low-grade irritation or minor trauma, or hormonal factors such as in lesions occurring during pregnancy and at puberty. The name PG is a misnomer, it was originally thought to be caused by pyogenic organisms.…”

A rapidly growing lesion on the lip

“…Pyogenic granuloma (PG) is a common vascular proliferation of the skin and mucous membranes . It is not pyogenic or granulomatous, and a reactive vascular response to trauma, female sex hormones, medications, infections or poor oral hygiene (in oral PG) seems to be implicated . PG is more prevalent in children, adolescents and pregnant women .…”

“…It is not pyogenic or granulomatous, and a reactive vascular response to trauma, female sex hormones, medications, infections or poor oral hygiene (in oral PG) seems to be implicated . PG is more prevalent in children, adolescents and pregnant women . Oral PG is more common in females in the second decade of life .…”

“…Oral PG is more common in females in the second decade of life . It typically presents as a solitary, pedunculated/sessile erythematous papule, with an erosive or friable surface, with rapid growth over weeks to months, occasionally to a few centimeters . It is usually painless and tends to bleed and ulcerate .…”

“…It typically presents as a solitary, pedunculated/sessile erythematous papule, with an erosive or friable surface, with rapid growth over weeks to months, occasionally to a few centimeters . It is usually painless and tends to bleed and ulcerate . In the oral cavity, PG is more common in the gingiva, lips, tongue and buccal mucosa .…”