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pyogenic granuloma

Definition
A pyogenic granuloma is a collection of blood vessels that grow quickly and abundantly, often at the site of an injury.

What is going on in the body?
The cluster of blood vessels making up the pyogenic granuloma forms a dark red spot that becomes ulcerated and crusts over. This process usually takes 1 to 2 weeks. It is considered an abnormal healing response. Normally, blood vessels respond with growth to help heal a traumatic site. In this condition, it's as if the response is excessive and doesn't know when to turn off.

What are the signs and symptoms of the disease?
A pyogenic granuloma is usually a bright red or dark purple-red blood vessel nodule. This lesion is dome-shaped, protrudes from the skin, and is usually solitary. It can bleed easily, especially after re-injury. The nodules seem to be more common on the face, hands, arms, and shoulders. At first the lesions may be about the size of a pinhead. They may grow rapidly up to 1 cm in size.

What are the causes and risks of the disease?
The cause of pyogenic granuloma is unknown. It is most common in children and young adults, and may occur during pregnancy. The hormonal changes that pregnant women and children undergo may be a contributing factor.

What can be done to prevent the disease?
Since the cause of pyogenic granuloma is not known, prevention is difficult. Avoiding injury may decrease the risk, but that is not always possible.

How is the disease diagnosed?
The diagnosis of pyogenic granuloma is usually based on a physical examination. A biopsy of the skin and tissue at the site may be done to rule out other causes for the skin lesion.

What are the long-term effects of the disease?
The long-term effects of pyogenic granuloma are generally limited to annoying bleeding at the site. The lesions do not usually hurt or itch.

What are the risks to others?
Pyogenic granuloma is not contagious and poses no risk to others.

What are the treatments for the disease?
Pyogenic granuloma lesions may be removed with surgery. The surgeon makes an incision into the skin and removes the granuloma or takes a biopsy sample of it. Cryosurgery may be used to freeze the lesion off. Electrocautery is another way to remove the lesion, using heat.

What are the side effects of the treatments?
Usually a minor scar is left by the lesion and the surgery. Surgery poses a risk of bleeding, infection, or allergic reaction to anaesthesia.

What happens after treatment for the disease?
Pyogenic granuloma usually goes away completely after treatment or on its own. Occasionally, it may come back.

How is the disease monitored?
If bleeding at the site does not stop despite applying pressure for 10 minutes, the doctor should be contacted. Any new or worsening symptoms should also be reported to the doctor.

Author: Lynn West, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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