What is Pyogenic Granuloma?
These are reddish bumps, small, on the skin which bleed quite easily because of an atypical high number of blood vessels. They are fairly common growths of skin. The bumps ooze and bleed so that they can look like hamburger meat which is rare. Usually they seem to develop after an injury that is minor which grows quickly over a time of a few weeks to a size of about ½ of an inch. The neck, head, upper trunk, as well as the feet and hands are the sites that are more common for growth.
These growths will happen at every age, except are least frequent in those extremely young as well as the extremely old. Most often it is seen in children, pregnant women where they are called pregnancy tumor, as well as those individuals who are using the drugs, Indinavir, Accutane, Soriatane, as well as oral contraceptives.
These lesions are almost always benign. But there is still always the worry that they might be cancerous and infrequently a cancer can imitate pyogenic granuloma. A section can be taken for biopsy examination. This is normally important because almost half of cases treated will grow back and will need a 2nd treatment.
Those growths which emerge on the upper back of adolescents are the ones most apt to recur. There are times when several smaller lesions can form following treatment and are known a “satellites”. It is believed that parts of these growths can spread thru neighboring blood vessels. These growths in women who are pregnant can leave after delivery entirely and often waiting is the paramount method of treatment in these cases.
Pyognic Granuloma Causes
These lesions are caused by the growth of many small blood vessels. It may be several cm or up to one inch in diameter. They may be found almost anywhere on the skin as well as even on the gums in the mouth. The cause is unknown. They develop often after some sort of trauma. They can also frequently develop during early stages of a pregnancy and usually go away after the pregnancy ends.
A diagnosis is deduced if there is a history of a flesh colored or reddish dome shaped lesion which occurs over the cours of a very few days to 3 weeks as well as easily bleeds. It may be confused with many other lesions for instant a form of melanoma referred to as amelanotic melanoma. This cancer of the skin without pigment normally occurs more slowly. There are also many other lesions that are noncancerous which can be confused with Pyogenic granuloma. Some of these are moles or benign nevi as well as a lesion known as dermatofibrosis. A biopsy as well as microscopic assessment of this lesion is usually needed in order to confirm what type of lesion it is.
The lesions of pyogenic granulomas normally occur in individuals of all races. Females are most frequently affected by these than male, although boy and girl children are affected equally
Pyogenic Granuloma Symptoms
Common locations for pyogenic granulomas include:
- Gums, lips as well as inner mouth especially in women who ware pregnant
- Fingers as well as hands
- Toes as well as feet
- Upper part of trunk
Normally, pyogenic granulomas look like a beefy, red bump which enlarges rapidly over a few weeks. On the average, pyogenic granulomas are approximately 5 to 10 mm in diameter. They can bleed easily and in mot cases can be quite tender. Rarely more than 1 lesion can grow at the same site at the same time.
These lesions are more often seen in:
- Women who are pregnant
- Young adults as well as children
- Women who are taking any type of oral contraceptives
- Individuals on chemotherapy
- Individuals taking certain types of oral retinoid drugs including isotretinoin or acitretin
- Individuals taking protease inhibitors such as indnavir
An individual should see their primary care physician if they notice any skin growth which is rapidly enlarging. This is to establish the correct diagnosis. Since there is a propensity to easily bleed, these lesions should be covered with some sort of bandage until the doctor is seen.
Make an immediate appointment with your primary care physician or a dermatologist if there is rapid enlarging or bleeding of any growth occurring on the skin especially in the lining of the mouth or nose.
If the diagnosis of pyogenic granuloma is possible, the doctor probably will need to do a skin biopsy. This is a procedure which involves:
- Numbing the skin by injectable anesthetic
- Sampling of a small piece of skin by the use of a razor blade which is flexible, a scalpel or a tiny punch biopsy instrument. If a punch biopsy is used, a couple of stitches will need to be placed and then removed in 6 to 14 days later.
- Skin sample examined under the microscope by a dermatopathologist which is a pathologist who specializes in skin conditions.
A pyogenic granulomas lesion on a pregnant woman will often go away after the delivery. Also, one of these lesions caused by medication will normally improve when the drug is discontinued or the dosage of the drug is reduced. Depending on the size of the lesion as well as its symptoms and location, the physician can decide if no treatment is needed for a pregnant woman or for individuals who can safely lower or stop the medication which causes the lesion.
Even though pyogenic granuloma is a condition that is benign, it is often removed because of the tendency to bleed, its tenderness as well as its anguishing appearance. But, untreated pyogenic granulomas can and usually will go away on their own.
In cases which are obviously pyogenic granuloma, the physician can decide to treat it immediately upon obtaining the biopsy. Such treatment includes:
- Curettage and cauterization also known as scraping and burning. After numbing with local anesthetic, the area is scraped with a sharp device and then burned with a needle which is electric.
- Solution of silver nitrate
- Laser treatment
- Topical cream of Imiquimod
- Surgical excision/removal
It is estimated that 40% of these lesions return after treatment, particularly those located on the trunk of young adults or teenagers. Pyogenic granulomas which recur are considered to best be treated by surgical removal.