Pyogenic Granuloma

Definition

• A benign, rapidly growing vascular lesion that appears as a red, fleshy bump (often described as "raspberry-like"). It’s prone to bleeding and potential ulceration with minor trauma.

Aetiology & Causes

• Trauma: Minor injuries can stimulate vascular proliferation.

• Infection: Staphylococcus aureus can be present and trigger or exacerbate growth.

• Hormonal: Occurs in ~5% of pregnancies or with OCP use.

• Medications: Retinoids, certain cancer therapies.

Clinical Features

• Painless, red nodule (1–2 cm), can grow quickly over weeks.

• Easily bleeds with minimal trauma.

• Common locations: Head, neck, upper trunk, hands, feet.

Diagnosis

• Primarily clinical based on characteristic appearance and rapid growth history.

• Biopsy if there is any suspicion of malignancy (e.g. melanoma, BCC, amelanotic or nodular lesions).

Management

1. Curettage & Cautery

   • Scraping (curette) the lesion followed by electrocautery to prevent regrowth.

2. Laser Therapy

   • Useful for smaller lesions or cosmetically sensitive areas.

3. Cryotherapy

   • Freezing small lesions with liquid nitrogen; may require multiple sessions.

4. Chemical Cautery

   • Application of silver nitrate to control bleeding and destroy tissue superficially.

5. Imiquimod

   • Occasionally effective, especially in children, though less commonly used.

6. Pregnancy-related Lesions

   • May resolve postpartum; wait and watch approach if lesion isn’t problematic.