Pyogenic Granuloma: Signs, Causes, Symptoms, How to Treat

Pyogenic granuloma is a condition where there is proliferation of capillary blood vessels. Pyogenic granulomas usually appear as shiny red lumps with a raspberry or minced meat-like surface. Although benign, pyogenic granulomas can cause discomfort and profuse bleeding.

Pyogenic granuloma is usually also called lobular capillary hemangioma, granuloma pyogenicum, and granuloma telangiectaticum.

Causes and Risk Factors of Pyogenic Granuloma

The cause of pyogenic granuloma is currently unknown. However, there are several factors that have been identified as having a possible role in the development of pyogenic granulomas, these factors are:

• Trauma: in some cases pyogenic granulomas can appear at the site of a minor injury, such as a pinprick.
• Infection: Staphylococcus aureus bacteria are more common
• Hormonal influence: pyogenic granuloma occurs in up to 5% of pregnancies and is sometimes associated with the use of oral contraceptives.
• Drug-induced: multiple pyogenic granulomas sometimes appear in patients taking oral retinoids (acitretin or isotretinoin) or protease inhibitors.

Pyogenic granuloma can occur in people of all races. Women are affected by pyogenic granulomas more often than men. The following are several risk factors for pyogenic granuloma:

• Children and adults
• Pregnant women
• People undergoing chemotherapy

Signs and Symptoms of Pyogenic Granuloma

Pyogenic granulomas usually first appear as red, brownish-red or blue-black spots that do not cause pain. Pyogenic granulomas grow rapidly over several days to weeks to a final size of 1-2 cm (rarely up to 5 cm). Pyogenic granulomas usually bleed easily and may cause sores to form crusts on the skin. Usually pyogenic granulomas appear in single numbers, but in rare cases more than one pyogenic granuloma can also appear.

Pyogenic granulomas are most often found in the head, neck, upper body, hands (especially fingers) and feet. Meanwhile, pyogenic granulomas in pregnancy most often occur on the mucosal surface of the lips or in the oral cavity.

How to Prevent the Occurrence of Pyogenic Granuloma

Because the cause is still unknown, until now it is not known for certain how to prevent pyogenic granulomas from occurring.

See your doctor if you notice a rapidly enlarging skin growth to get a correct diagnosis. Because pyogenic granulomas bleed easily, pyogenic granuloma lesions must be covered with a bandage until you go to the doctor.

How to Treat Pyogenic Granuloma

Diagnosis

Pyogenic granuloma is usually diagnosed clinically because of its characteristic appearance. Examination with histology results can usually confirm the diagnosis, especially to differentiate a form of skin cancer such as amelanotic melanoma which is a differential diagnosis from pyogenic granuloma. In pyogenic granuloma histology results can show lobular collections of blood vessels in the inflamed tissue.

However, if the doctor suspects a pyogenic granuloma, the doctor will usually perform a skin biopsy.

Treatment

Generally, pyogenic granulomas can disappear by themselves, especially pyogenic granulomas associated with pregnancy. If the pyogenic granuloma is caused by a drug, it will usually disappear when the drug is stopped.

There are several methods that can be used to remove pyogenic granulomas. These methods include:

• Curettage and cauterization: this procedure is carried out by scraping the granuloma with a curette and the blood vessels are cauterized or burned to reduce the possibility of the granuloma growing again.
• Laser surgery can be used to remove lesions and burn the underlying surface, or pulse dye laser can also be used to shrink small lesions.
• Cryotherapy may be suitable for small lesions.
• Chemical cauterization using silver nitrate is effective for small lesions.
• Imiquimod cream has been reported to be effective and may be particularly beneficial in children.
• Topical propranolol 1% ointment has been shown to be effective when used early in children with pyogenic granulomas.

Recurrence after treatment often occurs because the proliferation of blood vessels has extended deep into the dermis. In these cases, the most effective removal method is to cut the affected part (excision), which is then closed with stitches.

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