PYOGENIC GRANULOMA
PYOGENIC GRANULOMA ICD-10: L98.0
• Pyogenic granuloma is a rapidly developing vascular lesion usually following minor trauma.
• This is a very common solitary eroded vascular nodule that bleeds spontaneously or after minor trauma (Fig. 9-17A). It appears as a bright red, dusky red, violaceous, or brown-black papule with a collar of hyperplastic epidermis at the base (Fig. 9-17B), and most commonly occurs on the fingers, lips, mouth, trunk, and toes.
• Histopathology: Lobular aggregates of proliferating capillaries with edema and numerous neutrophils. Thus, pyogenic granuloma is neither pyogenic (associated with bacterial infection), nor a granuloma.
• Treatment is surgical excision or curettage with electrodesiccation at the base.
• The importance of pyogenic granuloma is that it can be mistaken for amelanotic nodular melanoma, and vice versa.
A B
FIGURE 9-17 • Pyogenic granuloma (A) This is a solitary vascular nodule of recent onset that bleeds spontaneously or after minor trauma. The lesions usually have a smooth surface, with or without crusts and with or without erosion. (B) On palms and soles, they have a typical collar of thickened stratum corneum at the base. This collar can best be seen when viewed from the side.