What is a pyogenic granuloma (lobular capillary hemangioma)?

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From the Guidelines

Pyogenic granuloma is a common acquired vascular lesion of the skin and mucous membranes, also known as lobular capillary hemangioma, which is neither pyogenic nor granulomatous. This condition primarily affects infants and children and is frequently misdiagnosed as infantile hemangioma 1. The lesions are most commonly located on the head and neck, rapidly enlarge, and frequently develop a pedunculated base, making them prone to bleeding that is difficult to control 1.

Key Characteristics

  • Commonly affects infants and children
  • Located on the head and neck
  • Rapidly enlarges
  • Prone to bleeding
  • Not infectious or granulomatous

Diagnosis and Treatment

Pyogenic granulomas can be diagnosed based on their clinical appearance and history 1. Treatment options include surgical excision, shave removal with electrocautery, laser therapy, or cryotherapy, with surgical removal being most effective to prevent recurrence 1.

Important Considerations

  • Pyogenic granulomas are benign and not cancerous
  • Should be evaluated by a healthcare provider to confirm diagnosis and determine appropriate treatment
  • Pregnant women may experience regression of these lesions after delivery, so conservative management may be appropriate in such cases 1
  • The exact cause remains unclear, but involves abnormal proliferation of vascular tissue in response to various triggers 1

From the Research

Definition and Characteristics of Pyogenic Granuloma

  • Pyogenic granuloma is a benign vascular tumor that can occur on the skin or subcutaneous tissue 2, 3, 4.
  • It is characterized by a rapidly growing benign vascular tumor 2 and consists of capillary proliferations, venules, and fibromyxoid stroma 3.
  • Pyogenic granuloma can affect both skin and mucous membranes 3 and can occur in all ages 5, 3, 4.

Clinical Presentation and Symptoms

  • Pyogenic granuloma often presents with bleeding, which can be persistent and may occur after minor trauma 5.
  • The tumor can mimic various other vascular lesions, solid tumors, and soft tissue infections 3.
  • Bleeding is a common symptom of pyogenic granuloma 3.

Treatment Options

  • Surgical procedures, including laser therapy, are the backbone of treatment for pyogenic granuloma 3, 4.
  • Other treatment options include topical and systemic beta-adrenergic receptor antagonists, such as timolol and propranolol 3, 6.
  • Direct pressure with a nonadherent dressing remains a first-line treatment for bleeding pyogenic granulomas 5.
  • Additional therapeutic options, such as dressings impregnated with topical vasoconstrictors or hemostatic dressings or agents, can be used if bleeding persists 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

[Pyogenic granuloma].

Ugeskrift for laeger, 2021

Research

Management of Bleeding Pyogenic Granulomas in Acute Care Settings.

The Journal of emergency medicine, 2022

Research

Therapeutic approaches to pyogenic granuloma: an updated review.

International journal of dermatology, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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