Pyogenic granuloma is a
relatively common skin growth. It is usually a small red, oozing and
bleeding bump that looks like raw hamburger meat. It often seems to
follows a minor injury and grows rapidly over a period of a few
weeks to an average size of a half an inch. The head, neck, upper
trunk and hands and feet are the most commonly sites.
Pyogenic granuloma can
occur at any age, but is least common in the very young and the very
old. It is seen most often in children, pregnant women (“pregnancy
tumor”) and those taking the drugs Indinavir, Soriatane, Accutane
and oral contraceptives.
Pyogenic granulomas are
always benign growths. Still there is always a concern that they
could be cancerous, and rarely a cancer can mimic pyogenic granuloma.
A sample is usually obtained for biopsy analysis. This is
particularly important since as many as half of treated cases will
recur (grow back) and need a second treatment.
Those that appear on the
upper back in young adults are more prone to recur. At times
multiple smaller pyogenic granulomas form following a treatment
(these are known as “satellites”). It appears that pieces of
pyogenic granuloma may spread though local blood vessels. Pyogenic
granulomas in pregnant women may go away after delivery on their
own, and sometimes waiting is the best strategy in those cases.
Most pyogenic granulomas
are scraped off with an instrument called a curette and lightly
cauterized to decrease the chance they will re-grow. An injection of
local anesthesia is required (lidocaine is used-similar to Novocaine).
Some doctors prefer to treat with “acids” (TCA, podophyllin,
phenol, silver nitrate). Laser surgery can also be done but has not
been proven to be superior. The highest cure rates are obtained when
the growth is removed by full thickness surgical excision, and
closed with stitches.