Pyogenic granuloma is a benign, acquired, vascular neoplasm of the skin and mucous membranes. Interestingly, it doesn’t have an infective aetiology in spite of its’ name. The term granuloma pyogenicum was first adopted because of the presumed infectious aetiology and presence of granulomatous inflammation. The exact pathogenesis is uncertain but an infective aetiology has never been proven.
The term lobular capillary haemangioma has been proposed as an alternative name in recent times.
They are common on the head, neck, fingers and periungal areas. They are small, red papules that grow rapidly and then stabilize. They are usually solitary.
They characteristically present to ED with profuse bleeding after minimal trauma.
Management in the ED involves measures to obtain haemostasis e.g pressure bandages, Kaldostat® or cauterization with silver nitrate.
Recurrent bleeding occurs if the lesion is not definitively removed. Options include: surgical excision with primary closure, shave excision at the base followed by electrocautery, cryotherapy or laser therapy.
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