Pyogenic granuloma. Smooth, glistening, red papule on the face.
Multilobular red papule of pyogenic granuloma.
CLINICAL FEATURES
Pyogenic granuloma is misnamed, given that the lesions are neither pyogenic or granulomatous. Microscopically, they resemble a capillary hemangioma and should best be called acquired lobular capillary hemangiomas to differentiate from a hemangioma of infancy. They are common in children and appear as 3–10-mm solitary, dull red firm papules predominantly on the face, arms and hands. The surface may be smooth or glistening, but is often ulcerated and crusted. The lesions bleed easily when traumatized. They may arise at sites of injury, but a history of trauma is usually not elicited.
TREATMENT
Removal with an open curette followed by cauterization of the base is the most successful therapy. Facial lesions less than 5 mm in size in young children may be treated with PDL (pulsed dye laser), but multiple treatments are often necessary and the treatment is not always successful. When PDL therapy is successful scarring is often prevented. Pyogenic granulomas should not be surgically excised and sutured, because this frequently leads to the formation of multiple lesions on and around the surgical scar.
