What is pyogenic granuloma?
A pyogenic granuloma (PG) is a benign (not cancerous) red bump made of newly formed small blood vessels.
Another medical name for pyogenic granuloma is a “lobular capillary hemangioma.” PGs can happen anywhere on the skin, and they can appear at any age. PGs often grow quickly, and they may get a scab over the top. With time, PGs might bleed, especially if they are bumped or scratched.
WHAT CAUSES A PYOGENIC GRANULOMA?
PGs often appear after an injury. Sometimes it is hard to remember the injury as it may have been minor, for example, an insect bite or scratch. More rarely, PGs may appear with the use of certain medications, such as isotretinoin, or in birthmarks, such as port-wine stains. Sometimes a specific cause is not found.
HOW IS A PYOGENIC GRANULOMA DIAGNOSED?
PGs can usually be diagnosed clinically by their appearance and history. A biopsy or removal can give a definite diagnosis.
WHAT DO I DO IF MY CHILD’S PYOGENIC GRANULOMA IS BLEEDING?
When a PG is bleeding, it may seem like a lot of blood and may be frightening. However, PGs do not bleed enough to cause problems from blood loss.
To stop the bleeding, put some ointment (like petroleum jelly) on a cold washcloth and apply firm pressure to the PG for at least ten minutes. Watch the clock and try not to peek, because ten minutes feels like a long time. To make a cold washcloth, you can dampen the washcloth with cold water or put an ice pack in the washcloth. In most cases, just applying pressure will make the bleeding stop. If the bleeding cannot be stopped, call your healthcare provider.
TREATMENT OPTIONS FOR PYOGENIC GRANULOMA
Most PGs are removed by a shave biopsy after a numbing injection is given. Cautery is often used to prevent bleeding after the biopsy. Cautery stops bleeding by using heat to seal blood vessels closed. The removed bump should be sent to the lab to confirm the diagnosis. A shave biopsy is a quick procedure that can be done in a dermatologist’s office. It will leave a small round scar on the skin.
Other possible treatment options for small PGs are imiquimod cream or timolol solution.* Both of these medicines are applied to the surface of the PG. They may take two or more months to work. Neither of these treatments are 100% effective in making the PG go away, so some children will still need biopsy removal.
* Both Imiquimod and timolol are medicines that are approved for use in adults or children by the FDA for other conditions. Using either of these medicines to treat PGs is considered “off-label” use.
Another treatment option for PGs is laser. There are several types of lasers that treat blood vessels. These lasers can be used to treat PGs. Laser works best on small PGs that are not bleeding very much. Laser can be done with a numbing injection, numbing cream, or without any numbing.
Occasionally, PGs come back after they are treated or a new PG occurs in another area. If this occurs, you should call your healthcare provider.
© 2018 The Society for Pediatric Dermatology