What is it
In response to injury, the body forms granulation tissue rich in new capillaries - this is a normal part of healing. In pyogenic granuloma, this process gets out of control and the vascular tissue continues to grow, forming a protruding nodule. Its surface is easily injured and wet, and the walls of the blood vessels are so thin that bleeding occurs from the touch of clothing. The size is usually from a few millimeters to a centimeter, growth is rapid - in weeks. Despite its frightening appearance, the formation is benign and does not metastasize.
- Proliferation of small vessels, not infection
- Rapid growth in a few weeks
- Leg or wide base
- Easy bleeding from the slightest injury
- Favorite places: fingers, lips, face, gums
- A separate form is granuloma of pregnant women on the gum
Reasons
Most often, the trigger point is microtrauma: a needle prick, a splinter, a ripped off hangnail, an abrasion, an insect bite, damage during a manicure. The second significant factor is hormonal changes, primarily pregnancy, so such formations often appear on the gums in the second and third trimester and usually decrease after childbirth. Certain medications can also trigger the growth, including retinoids and certain anticancer drugs. Sometimes no obvious reason can be found.
- Minor injuries to the skin and mucous membranes
- Pregnancy and hormonal changes
- Manicure damage and ingrown toenails
- Taking retinoids and some anticancer drugs
- Chronic irritation of the skin area
- Sometimes the cause remains unknown
What does it look like and what is bothering you?
The formation is bright red, juicy, shiny, often on a narrow stalk, sometimes with a whitish collar at the base. It is painless, but it constantly gets in the way: it gets caught by clothes, is easily injured and bleeds, and it can be difficult to stop the bleeding. Over time, the surface may become crusty and wet. In pregnant women, the typical location is the interdental papilla of the gum, where the nodule interferes with chewing and brushing the teeth. The location on the fingers and in the nail area is especially unpleasant, because it is injured during any work with the hands.
- Bright red or purplish nodule
- Smooth shiny or wet surface
- Growth in a few weeks
- Excessive bleeding when touched
- No pain
- Localization on fingers, lips, face, gums
Diagnostics
As a rule, the diagnosis is made upon examination: the characteristic appearance, rapid growth and connection with recent trauma are quite recognizable. Dermatoscopy helps to see the vascular structure and whitish collar. However, external similarity is deceptive: non-pigmented melanoma, squamous cell carcinoma and vascular tumors can masquerade as pyogenic granuloma. That is why any removed lesion must be sent for histological examination, even if the doctor is confident in the diagnosis. An independent attempt to tie a knot with thread or cut it off deprives this opportunity and is dangerous for bleeding.
- Examination by a dermatologist or surgeon
- Dermatoscopy
- Mandatory histology of removed tissue
- History assessment: trauma, pregnancy, medications
- Refusal to self-delete
Treatment
Spontaneous disappearance is possible, especially in pregnant granulomas after childbirth, but usually the formation does not go away and continues to bleed, so it is removed. The most reliable method is excision within healthy tissue: with it, relapses are less likely and material for histology is always available. Curettage with cauterization of the base, laser and electrosurgical removal are also used. The key point is to treat the base: if part of the vascular tissue remains, the nodule grows again. For pregnant women, if there are no serious inconveniences, the doctor may suggest waiting until childbirth.
- Excision within healthy tissue
- Scraping with cauterization of the base
- Laser or electrosurgical removal
- Mandatory histological examination
- Observation in pregnant women with small sizes
- Proper care of the wound until complete healing