Pyogenic granuloma
| Pyogenic granuloma | |
|---|---|
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| Classification and external resources | |
| Specialty | dermatology |
| ICD-10 | L98.0 |
| ICD-9-CM | 686.1 |
| DiseasesDB | 29385 |
| MedlinePlus | 001464 |
| eMedicine | ped/1244 |
| MeSH | D017789 |
Pyogenic granuloma (also known as a "eruptive hemangioma", "granulation tissue-type hemangioma", "granuloma gravidarum", "lobular capillary hemangioma", "pregnancy tumor", and "tumor of pregnancy") is a vascular lesion that occurs on both mucosa and skin, and appears as an overgrowth of tissue due to irritation, physical trauma, or hormonal factors. It is often found to involve the gums, the skin and nasal septum, and has also been found far from the head such as in the thigh.
Pyogenic granulomas were first described in 1897 by two French surgeons, Antonin Poncet and Dor, who named these lesions botryomycosis hominis.
The name pyogenic granuloma is misleading as it is not a true granuloma. In actuality, it is a capillary hemangioma of lobular subtype, which is why such a lesion is prone to bleeding. Additionally, it is also not truly pyogenic (pus-producing), as the cause is hormonal or traumatic and has no association with infection or pus production.
The appearance of pyogenic granuloma is usually a color ranging from red/pink to purple, and can be smooth or lobulated. Younger lesions are more likely to be red because of the high number of blood vessels. Older lesions begin to change into a pink color. Size ranges from a few millimeters to centimeters. This is not to say that the pyogenic granuloma can not be bigger but it is more common to see one within these measurements. It can be painful, especially if located in an area of the body where it is constantly disturbed. Pyogenic granulomas can grow rapidly and will often bleed profusely with little or no trauma. Some cases may also include the granuloma "leaking" an oil like substance causing the surface to be damp. This is especially true if the granuloma is located on the scalp.
This lesion may be seen at any age, and there is a definite sex difference with more females affected than males. In pregnant women, it may occur in the first trimester with an increasing incidence up until the seventh month and is often seen on the gums. Epulis granulomatosum is a variant of pyogenic granuloma that forms only on gingiva, and are often seen forming in a recent extraction socket. Pyogenic granulomas appear on the gingiva in 75% of cases, more often in the maxillary than mandibular jaw. Anterior areas are more often affected than posterior areas. It can also be found on the lips, tongue, and inner cheek. Poor oral hygiene or trauma are usually precipitating factors.
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