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Pyogenic Granuloma

Pyogenic granuloma is a commonly occurring skin condition characterized by the presence of anomalous red shiny mass. The affected skin looks like raw minced meat or like raspberries. They are mostly non-cancerous, but can elicit bleeding and cause distress. Another name for the disorder is ‘granuloma telangiectaticum’ .

Pyogenic granuloma is usually categorized as an oral condition occurring in the form of a tissue overgrowth that is caused by irritation, physical injuries or hormonal problems. It is mostly found to occur in the nasal canals and the skin, but can also affect the distant areas like the thighs.

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Pyogenic granuloma was initially noted by 2 French doctors, Dor and Poncet. They called it botryomycosis hominis. As pyogenic granuloma is not a true type of granuloma, the name is not fully justified. The condition is in reality a capillary hemangioma from the lobular subtype, which is the reason for their propensity to bleed. It is also not truly pyogenic, as true ones are mostly not discomforting or infectious.

Symptoms of Pyogenic Granuloma

Some of the signs and symptoms of pyogenic granuloma are listed below:

  • The lesions associated with pyogenic granuloma can elicit different colors like reddish, pinkish or purplish. The baby lesions are mostly red in color due to elevated number of blood vessels in them, while the developed lesions are usually pinkish.
  • The lesions may either be lobulated or smooth
  • They tend to grow rapidly and experience elevated bleeding with nil or little harm
  • During the period of growth, the lesion size differs from 2 mm to 2mm diametrically. On occasions, they can measure nearly 5 cm
  • The lesions of pyogenic granuloma can be painful, more so if they appear in those body areas with higher risk to getting agitated
  • Pyogenic granuloma mainly tends to affect the gingiva. Hence, it is usually noticed to be present in conjunction with 2 other types of gingival diseases, i.e. peripheral giant cell granuloma and peripheral ossifying fibroma.
  • Pyogenic granuloma lesions are usually found occurring in children and young adults. Women are at greater risk to the condition as opposed to men
  • The lesions may also affect the lips, tongue and interiors of the cheeks. Poor oral hygiene and injuries are thought to be the probable triggers and exacerbating factors
  • Expectant women are at greater susceptibility to developing pyogenic granuloma during the 1st trimester, with gradual progress in the rate of appearance till the seventh month. It is mainly seen on the anterior area of the nasal septum and results in chronic nosebleeds
  • Examination of the lesions under a microscope shows the occurrence of increasingly vascular granulation tissue. The more mature lesions tend to exhibit a fibrous character along with ulceration of the surface. Inflammation is also present.
  • On certain occasions, localized mild trauma may lead to the formation of pyogenic granuloma in the conjunctiva, cornea or connective tissue of the eye. The appearance of such lesions is similar to those occurring at the usual sites.

Causes

The precise cause of pyogenic granuloma is currently unknown.

The many risk factors which can increase the vulnerability to developing pyogenic granuloma are listed below:

  • Some cases of pyogenic granuloma have been found to occur at sites of recent mild injuries, such as a needle or pin prick.
  • Hormone imbalances are rarely linked to oral contraceptives, but have been found to affect 5 percent of pregnant women
  • Most cases of pyogenic granuloma are often caused by infection with the Staphylococcus aureus bacteria
  • Intake of medications like systemic retinoids or protease inhibitors can increase the risk to occasional development of many lesions
  • Malformation of the blood vessels at a specific location can increase the risk to developing pyogenic granuloma at that site
  • Infection by viruses is considered as a possible trigger, but is yet to be empirically substantiated

Pyogenic Granuloma Treatment

  • Pyogenic granuloma occurring in pregnant women tends to disappear after he baby’s birth. Therefore, the best option in such instances is to wait and watch.
  • Drug induced cases can be solved once the affected individuals stop the intake of the medication

Pyogenic granuloma caused due to other reasons can be treated in any of the below listed ways:

  • Curettage and cauterization is a procedure involving the use of a curette to scrape off the skin anomalies. The blood vessels responsible for feeding the lesions are later cauterized to reduce the risk of recurrence
  • Imiquimod is a treatment technique that is particularly useful in child patients
  • Cryosurgery involves the use of liquid nitrogen to freeze off the pyogenic granuloma lesions and thus destroy them
  • Laser therapy is another effective way to remove the lesions and burn the skin occurring beneath. Tiny lesions can be contracted via a pulse dye laser
  • Chemical cauterization of the skin abnormalities by using silver nitrate is also an option
  • Surgical excision of the entire affected section of skin is a permanent treatment method that prevents recurrence. The resultant wound is then stitched up.

Pyogenic Granuloma Pictures

 

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