DS18 Efficacy of intralesional sodium tetradecyl sulfate in pyogenic granuloma

Abstract

Abstract Data on sclerotherapy in pyogenic granuloma (PG) are sparse and limited to a few case reports and series (Plachouri KM, Georgiou S. Therapeutic approaches to pyogenic granuloma: an updated review. Int J Dermatol 2019; 58:642–8). We present a series of 18 patients with PG treated with intralesional sodium tetradecyl sulphate (STDS). The aim of this study was to evaluate the efficacy, safety and recurrence rates of STDS sclerotherapy in the treatment of PG. Eighteen patients with PG (based on history and clinical features) of any age consenting to be part of the trial were included. Intralesional STDS 1% was injected slowly using an insulin syringe until the lesion blanched, and a maximum of 1 mL was used in one sitting. Patients were followed-up weekly; if the lesion did not show complete resolution, repeat injections were given up to a maximum of three sittings. A final assessment for relapses was done at 4, 8 and 16 weeks after treatment completion. All patients had complete clearance (100%) of the lesions with STDS 1% in one or two sittings. Noted side-effects included pain (n = 6), oedema (n = 4), purpuric staining (n = 2), paraesthesia (n = 1), ulceration (n = 2), necrosis (n = 2) and urticarial rash (n = 1). All side-effects resolved completely; two patients had to take analgesics and oral antibiotics. No bleeding episodes occurred in any patient after the first sitting. Further, none has shown recurrence over a follow-up period of 4 months. Eight patients developed mild atrophic scars as post-treatment sequelae. Sclerotherapy is a simple procedure; however, surprisingly, the literature on its use in PG, a very suitable indication for sclerotherapy by virtue of the pathology involved, is sparse. In this study, STDS successfully cleared the lesions in all patients without major complications or recurrence.