pyogenic granuloma ;granuloma telangiectaticum; lobular capillary hemangioma

Introduction

A rapidly developing hemangioma occasionally occurring at sites of minor trauma.

Etiology

• minor trauma
• medications, such as indinavir

Epidemiology

• children & adults < 30 years old
• no sex predilection

Pathology

• proliferation of capillaries
• prominent endothelial cells within edematous, gelatinous stroma
• epidermis is commonly eroded
• dense infiltrate of neutrophils is common

* histopathology image

Clinical manifestations

• solitary erodied vascular nodule that bleeds spontaneously or following minor trauma
• bright red, dusky red, violaceous or brown-black nodule with smooth surface < 1.5 cm in diameter
• dome-shaped, sessile or pedunculated
• occurs as solitary lesion on finger, lip, mouth, trunk or toe
• may be epidermal collarette at base on palm or sole
• lesions may persist for months

* images

Laboratory

• biopsy with histological examination

Differential diagnosis

• nodular malignant melanoma (may be amelanotic)
• squamous cell carcinoma
• glomus tumor
• nodular basal cell carcinoma
• metastatic carcinoma
• bacillary angiomatosis

Management

• biopsy with histological examination
• surgical excision (recurrence uncommon)
• curettage of scissor excision (for histopathology) followed by electrodessication or pulse dye laser (lesions may recur)

More general terms

• nevus
• cutaneous hemangioma