Notes and photos from dermnet –https://www.dermnetnz.org/topics/pyogenic-granuloma/
basal cell carcinoma
is a relatively common, reactive of blood vessels. It presents as a shiny red lump with a raspberry-like or minced meat-like surface. Although they are , granulomas can cause discomfort and profuse bleeding.
is also called lobular , pyogenicum and telangiectaticum.
What causes ?
The cause of is unknown. The following factors have been identified as having a possible role in their development.
Trauma: some cases develop at the site of a recent minor injury, such as a pinprick.
: Staphylococcus aureus is frequently present in the .
Hormonal influences: they occur in up to 5% of pregnancies and are sometimes associated with an oral contraceptive.
Drug-induced; multiple lesions sometimes develop in patients on an oral (acitretin or isotretinoin) or a .
Viral is possible but not proven.
What are the signs and symptoms of ?
usually first appears as a painless red, brownish-red or blue-black spot. It grows rapidly over a period of a few days to weeks to a final size of 1–2 cm (rarely up to 5 cm). It typically bleeds easily and may ulcerate to form a crusted sore. Usually a single is present but in rare cases multiple lesions may develop.
They are most frequently found on the head, neck, upper trunk, hands (especially fingers) and feet. The pregnancy variant of most often occurs on the mucosal surfaces of the lip or inside the mouth.
How is diagnosed?
is usually diagnosed clinically because of its typical time course and appearance.
confirms the diagnosis, especially if a form of skin such as amelanotic melanoma is in the . reveals a lobular collection of blood vessels within inflamed tissue.
What treatment is available for ?
granulomas may go away on their own, particularly those associated with pregnancy. If due to a drug, they usually disappear when the drug is stopped.
There are several methods used to remove .
Curettage and cauterisation: the is scraped off with a curette and the feeding blood vessel cauterised to reduce the chances of re-growth.
Laser surgery can be used to remove the and burn the base, or a pulse dye laser may be used to shrink small lesions.
Cryotherapy may be suitable for small lesions.
Chemical cauterisation using silver nitrate is effective for small lesions.
Imiquimod cream has been reported to be effective and may be particularly useful in children.
Experimentally, topical 1% propranolol ointment has proved effective when used early in children with .
after treatment is common because feeding blood vessels extend deep into the in a cone-like manner. In these cases, the most effective method of removal is to completely cut out the affected area (), which is then closed with stitches.