Pyogenic granuloma #

• When the capillary loops grow too vigorously, they may form a protruding mass of tissue that becomes covered with epithelium and is called a pyogenic granuloma.

History #

• Symptoms
  • history of a minor injury.
  • sometimes following chronic infection eg: paronychia.
• rapidly growing skin lump.
• bleeds easily.
• discharges serous or purulent fluid.
• double in size in a few days.

Examination #

• Site - found where injuries are most likely to occur (hands and face).
• Shape and size
  • They begin as a hemispherical nodule that grows upwards and outwards
• Surface
  • Before the surface is epithelialized, it has a covering of dried blood or plasma, and bleeds easily.
• Colour
  • Bright red: At first, they are the bright red colour of healthy granulation tissue
  • Pale pink: but as they get bigger and less vascular, they fade to a pale pink.
  • White: When they become covered with epithelium, they turn pink or white.
• Tenderness They are sometimes slightly tender.
• composition - feel soft.
• Relations - confined to the skin.
• Natural history
  • nodule begins to shrink.
  • but it rarely completely disappears.
• Differential diagnosis
  • Squamous carcinoma.
  • Non-pigmented melanoma.
  • Kaposi’s sarcoma.