What are the other Names for this Condition? (Also known as/Synonyms)

• Eruptive Hemangioma
• Granuloma Telangiectaticum
• Lobular Capillary Hemangioma

What is Pyogenic Granuloma? (Definition/Background Information)

• Pyogenic Granuloma is a common benign tumor involving the blood vessels observed commonly on the mouth or skin. These tumors may be single or multiple and may grow rapidly
• An individual may experience a painful, raised mass at the site. In others, the tumor may be asymptomatic, causing no signs or symptoms. Any trauma or irritation of Pyogenic Granuloma can make the condition worse
• The treatment of choice is a complete surgical removal through simple excision; the prognosis of Pyogenic Granuloma is excellent with suitable treatment
• Currently, no known methods exist to prevent Pyogenic Granuloma occurrence

Who gets Pyogenic Granuloma? (Age and Sex Distribution)

• Pyogenic Granulomas may occur in individuals of all age group
• Females are more often seen with this tumor than males
• There is no predilection to any ethnic group or a particular race; the condition is observed worldwide

What are the Risk Factors for Pyogenic Granuloma? (Predisposing Factors)

Risk factors for Pyogenic Granuloma development may include the following:

• They may occur spontaneously, as a response to an injury or a trauma
• Pyogenic Granulomas are more commonly seen during pregnancy
• The use of certain drugs and medications, resulting in drug-induced Pyogenic Granuloma
• Poor oral and dental hygiene

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pyogenic Granuloma? (Etiology)

• The exact cause of Pyogenic Granuloma formation is presently unknown
• They are thought to occur or as a reaction to a trauma or irritation to the region, which may result in abnormal blood vessel proliferation, since in about 30% of the cases, there is a history of trauma

What are the Signs and Symptoms of Pyogenic Granuloma?

Signs and symptoms of Pyogenic Granuloma include:

• They may be present as well-defined, raised, single or multiple nodules; some may be asymptomatic
• Some tumors may grow fast and then stabilize in size; they can become smaller and disappear completely
• Pyogenic Granulomas may range in size from 0.5-2.5 cm; large tumors may be painful
• Most common locations of the tumors are the skin and the mouth (oral mucosa)
• The tumors may ulcerate and ooze or bleed; scratching these tumors may increase bleeding
• Difficulty in chewing or swallowing, if the ulcer is present in the mouth (gums or cheek)

Note: Due to the rapid growth of some of the tumors, one may be concerned about a more malignant growth such as an angiosarcoma.

How is Pyogenic Granuloma Diagnosed?

A diagnosis of Pyogenic Granuloma is made using the following tools:

• Complete physical examination with a thorough evaluation of medical history
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• A tissue biopsy of the tumor: A tissue biopsy is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together the clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be the gold standard, in arriving at a conclusive diagnosis
• Differential diagnosis to eliminate other tumor types is often considered, before arriving at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pyogenic Granuloma?

The complications from Pyogenic Granuloma could include:

• Recurrence of the tumor after incomplete surgical removal; studies reveal a 15% chance in such cases
• Sometimes, after treatment, multiple small tumors may arise in the region called satellite nodules of Pyogenic Granuloma
• Bleeding and ulceration of the lesions can cause secondary bacterial or fungal infections to develop
• Some individuals may feel stressed due to the presence of these tumors, or due to the cosmetic issues they create

How is Pyogenic Granuloma Treated?

Treatment measures for Pyogenic Granuloma include the following:

• A simple surgical excision with removal of the entire lesion is the preferred treatment method. If the tumor is not fully removed, it might recur
• Most lesions can be treated with electrodessication. Alternatively, the lesion may be removed for examination by a pathologist, and the base electrodesiccated
• For small moist lesions, silver nitrate chemocautery can destroy the proliferative vascular tissue
• A laser surgery can help reduce scar tissue formation
• If there are secondary infections, then it may be treated with antibacterial and antifungal medications
• Post-operative care is important until the surgical wound heals
• Follow-up care with regular screening and check-ups are important

How can Pyogenic Granuloma be Prevented?

Current medical research has not established a method of preventing Pyogenic Granuloma occurrence. However, the following may be considered:

• It is important to not pick or scratch the lesions, which can help decrease complications
• Maintaining good oral and personal hygiene may be helpful, which includes regular brushing and flossing of one’s teeth
• Regular medical screening at periodic intervals with blood tests, radiological scans, and physical examinations are mandatory, due to a higher Pyogenic Granuloma recurrence rate after treatment

What is the Prognosis of Pyogenic Granuloma? (Outcomes/Resolutions)

• The prognosis of Pyogenic Granuloma is excellent on their complete surgical removal. These tumors are not malignant
• The probability of Pyogenic Granuloma recurrence is high at 15% after surgical removal of the tumor. Hence, a regular follow-up with medical screening should be ensured

Additional and Relevant Useful Information for Pyogenic Granuloma:

Pyogenic Granuloma is also known as Lobular Capillary Hemangioma.