Timolol for Treatment of Recalcitrant Pyogenic Granulomas: a Case Report and Review of the Literature

Abstract

Importance: Pyogenic Granuloma (PG) is a benign vascular tumor that forms commonly on the face, oral mucosa, or a site of previous injury. Though some PGs resolve spontaneously, most require some-to-multiple form(s) of treatment to prevent bleeding, ulceration, and scarring. Current treatment options for PGs include cryotherapy, laser, electrodessication, curettage or shave excision, sclerotherapy, corticosteroid injections, and imiquimod 5% cream. Timolol 0.5% ophthalmic solution has been used as a noninvasive topical treatment for PG in the pediatric population.Objective: To present a case of successful treatment of a recalcitrant PG with topical timolol, and to report on the current literature for similar cases.Case Presentation: We present a case of a 40-year-old healthy female who developed a biopsy-proven PG on her index finger. This is the first reported case to successfully use tangential biopsy and electrodessication followed by twice daily topical Timolol to treat recalcitrant PG.Conclusions: This case supports the use of 0.5% Timolol ophthalmic solution and demonstrates that it is a safe and economical therapy for adult patients with recurrent PGs. A review of the current literature is discussed, and supports timolol as an easy and economical therapy option.