Pyogenic granuloma–like lesion associated with topical tazarotene therapy

Abstract

Granulation tissue and pyogenic granulomas may occur in association with the use of oral retinoids but have not been described with the use of topical retinoids. Tazarotene is a selective retinoic acid receptor agonist used topically in the treatment of psoriasis and acne. During a controlled clinical trial of tazarotene 0.1% gel for the treatment of scalp psoriasis, a pyogenic granuloma developed in the treated area of one subject in the active treatment group (confirmed by biopsy of the lesion). The lesion developed after 2 weeks of tazarotene treatment, and the patient denied any trauma to this site. The patient continued to apply tazarotene to the scalp for an additional 10 weeks but no additional lesions developed. Although there is a known association of systemic retinoids and pyogenic granuloma,1Campbell JP Grekin RC Ellis CN Matsuda-John SS Swanson NA Voorhees JJ Retinoid therapy is associated with excess granulation tissue responses.J Am Acad Dermatol. 1983; 9: 708-713Abstract Full Text PDF PubMed Scopus (78) Google Scholar, 2Exner JH Dahod S Pochi PE Pyogenic granuloma-like acne lesions during isotretinoin therapy.Arch Dermatol. 1983; 119: 808-811Crossref PubMed Scopus (83) Google Scholar, 3Valentic JP Barr RJ Weinstein GD Inflammatory neovascular nodules associated with oral isotretinoin treatment of severe acne.Arch Dermatol. 1983; 119: 871-872Crossref PubMed Scopus (18) Google Scholar, 4Hagler J Hodak E David M Sandbank M Facial pyogenic granuloma-like lesions under isotretinoin therapy.Int J Dermatol. 1992; 31: 199-200Crossref PubMed Scopus (25) Google Scholar we can only speculate about a relationship between topical tazarotene and pyogenic granuloma. The single occurrence of a pyogenic granuloma within an area treated with tazarotene does not show cause but probably does indicate the need for vigilance to see whether this association occurs again. If topical tazarotene can predispose patients to pyogenic granuloma formation, a feature not seen with other topical retinoids, it suggests that there may be features unique to tazarotene that could be related to its efficacy relative to other retinoids.