Dermatology Book

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Pyogenic Granuloma

Aka: Pyogenic Granuloma, Epulis Gravidarum, Lobular Capillary Hemangioma
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  1. Definition
    1. Highly vascular variant of Capillary Hemangioma
  2. Epidemiology
    1. Common lesion in children and young adults
  3. Causes
    1. Often idiopathic
    2. Trauma or Burn Injury
    3. Viral infection
  4. Symptoms
    1. Bleeding from friable lesion
      1. Occurs with minimal trauma
  5. Signs
    1. Characteristics
      1. Initial
        1. Small bright red to yellow dome-shaped Papule
        2. Moist, glistening surface
        3. Often pedunculated
      2. Later
        1. Fibrous lesion similar to fibroma
    2. Distribution
      1. Head and neck
      2. Extremities
        1. Finger tips
        2. Lateral nailfold (periungual)
      3. Gingiva
        1. Occurs in children and young adults
        2. Pregnant women (Epulis gravidarum)
          1. Resolves with delivery
      4. Eyelid (most common acquired Eyelid lesion)
  6. Differential Diagnosis
    1. Nodular Melanoma
      1. Elmets (1980) Cutis 25:164-8
  7. Management
    1. Shave excision with electrodesiccation and curretage
    2. Send lesion for pathology due to differential diagnosis
    3. Recurs if not completely excised
  8. References
    1. Habif (1996) Dermatology, Mosby-Year, p. 732
    2. Luba (2003) Am Fam Physician 67(4):729-38

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