Pyogenic Granuloma

Excerpt

Pyogenic granuloma (PG), sometimes known as granuloma pyogenicum, refers to a common, acquired, benign vascular tumor that arises in tissues such as the skin and mucous membranes (see Image. Pyogenic Granuloma). The scientifically accurate term for this entity is lobular capillary hemangioma. In the past, pyogenic granulomas were thought to be an exaggerated granulomatous reaction to an infectious or pyogenic insult, which led to the use of terms such as ‘pyogenic granuloma’ and ‘granuloma pyogenicum.’ However, the term pyogenic granuloma is a misnomer that may initially cause confusion.

The lesion grossly appears as a solitary, red, pedunculated papule that is very friable. Less commonly, it may present as a sessile plaque. It shows rapid exophytic growth, with a surface that often undergoes ulceration. This is often seen on cutaneous or mucosal surfaces. Among the latter, it is most commonly seen within the oral cavity. Rarely, it may occur at other sites within the gastrointestinal tract. When it occurs in the intraoral mucosa in the setting of pregnancy, notably on the gingiva, it is referred to as granuloma gravidarum, granuloma of pregnancy, or epulis gravidarum, usually in the second or third trimester. There is a case reported in the literature where a patient developed multiple disseminated lesions while on therapy with oral contraceptive pills and one report of the development of lesions after a renal transplant.