Recurrent Pyogenic Granuloma Research Articles

Corticosteroids as a conservative treatment for recurrent pediatric oral pyogenic granuloma: a case report and review of the literature

Corticosteroids as a conservative treatment for recurrent pediatric oral pyogenic granuloma: a case report and review of the literature

Sclerotherapy in Pyogenic Granuloma: An Open Uncontrolled Trial

Objectives: Pyogenic granuloma (PG) is a common, benign lesion of vascular origin. It may rapidly grow in response to an unknown stimulus that triggers endothelial proliferation. The treatment of PG using sclerosing agents is a novel approach to overcome drawbacks associated with other procedures. The crucial purpose of this study is to evaluate the efficacy and safety of detergent sclerosant, sodium tetradecyl sulphate (STS) in the management of PG. Materials and Methods: A total of 18 patients with PG, attending dermatology venereology and leprosy (DVL) outpatient department (OPD) were treated with sclerotherapy after obtaining written and informed consent. STS solution (3%, 30 mg/mL) was injected with insulin syringe slowly into the lesion until the lesion blanched up to maximum amount of 0.3 mL. Injection was repeated every week until resolution or up to a maximum of 4 doses. Follow-up evaluation was performed monthly, up to 3 months. Results: In our study, complete resolution was seen in all the patients. No complication occurred after injection. All the patients were followed up for 3 months and none of the lesions recurred over this duration. Conclusion: Sclerotherapy is effective and safe in the treatment of PG without any recurrence. This approach may become a first-line therapy option for PG, especially in cases of recurrent PG associated with bleeding, and in lesions over surgically inaccessible areas.

Management of liver clot following surgical excision of a recurrent pyogenic granuloma: A case report

Management of liver clot following surgical excision of a recurrent pyogenic granuloma: A case report

Treatment of recurrent pyogenic granuloma: Case report with 1.5-year follow-up

Treatment of recurrent pyogenic granuloma: Case report with 1.5-year follow-up

Recurrent pyogenic granuloma within a port wine stain

<p class="abstract">Pyogenic granuloma (PG) is a common vascular growth usually seen on the face and extremities following trauma, drugs like retinoids, antineoplastic agents or pregnancy. PG and port-wine stain (PWS) represent different types of vascular lesions that may rarely occur in association. PG arising in a PWS is usually reported following trauma, pregnancy or laser treatment of PWS. Any growth in a long-standing vascular lesion creates panic in the patient and a challenge to the physician, especially in the head and neck area. We report a case of recurrent PG emerging de novo in three different locations within the same PWS in a 24 year old male. A review of literature about the coexistence of both conditions is presented here, together with dermoscopic features.</p>

Recurrent pyogenic granuloma caused by intraosseous vessel: A case report

Pyogenic granuloma is a benign localized lesion of the skin and mucosa closely related to trauma, chronic irritation and hormonal changes. The method of treatment is surgical excision. But relapses can occur. For this reason, treatment with alternative methods such as cryotherapy, electrocautery and laser has been investigated in recent years. In this case, the cause of PG was a feeder vessel. The lesion was excised before and recurred within two weeks. An intraosseous feeder vessel was identified by a magnetic resonance imaging. This vessel was exposed and cauterized with electrocautery.

Recurrent pyogenic granuloma successfully treated with endoscopic submucosal dissection four months after endoscopic mucosal resection

Colonic pyogenic granuloma (PG), a rare hemangioma, which grows rapidly and bleeds, warrants removal by endoscopic mucosal resection (EMR) for accurate diagnosis [1]. However, patients showing recurrence after EMR often need to be treated by surgical resection. This report describes a case of recurrence of colonic PG after EMR successfully treated with endoscopic submucosal dissection (ESD).

Recurrent Pyogenic Granuloma caused by Intraosseous Vessel: A Case Report

Pyogenic granuloma is a benign localized lesion of the skin and mucosa closely related to trauma, chronic irritation and hormonal changes. The method of treatment is surgical excision. However relapses can occur. For this reason, treatment with alternative methods such as cryotherapy, electrocautery and laser has been investigated in recent years. In this case, the cause of PG was a feeder vessel. The lesion was excised before and recurred within two weeks. An intraosseous feeder vessel was identified by a magnetic resonance imaging. This vessel was exposed and cauterized with electrocautery.

Recurrent pyogenic granuloma with satellitosis in a 5-year-old child

A 5-year-old male child presented with multiple asymptomatic red raised lesions over the left lateral side of his abdominal wall since 2 years. Cutaneous examination revealed multiple bright red, nontender, dome-shaped papules, and nodules arranged discretely. At few places, the lesions coalesced to form plaques with crusting on the surface. The lesions appeared to be arranged in a peculiar manner; with an increased concentration of the lesions in the vicinity of an atrophic central scarred area (of previous surgery) and few satellite discrete papules and nodules away from it. The differential diagnoses of pyogenic granuloma (PG), epithelioid hemangioendothelioma, and bacillary angiomatosis were considered. Histopathological examination from a nodule revealed angiomatous tissue composed of dilated thin-walled capillaries and groups of poorly canalized vascular tufts located in the upper and mid dermis suggestive of PG. A diagnosis of recurrent PG with satellitosis in a 5-year-old child was made. This case is described for the rarity of the condition in children and to emphasize the alarming presentation of a benign condition.

A Case Report of Recurrent Pyogenic Granuloma with Satellitosis

Recurrent pyogenic granuloma with satellitosis is an uncommon condition with majority of cases resolving within one year after treatment. We report a case of recurrent pyogenic granuloma in a middle aged man who kept on relapsing at different point of time despite treatment with electrocoagulation, cryosurgery and oral methotrexate. The case highlights the unusual presentation of relatively common condition of pyogenic granuloma.

A Case Report of Recurrent Pyogenic Granuloma with Satellitosis

Recurrent pyogenic granuloma with satellitosis is an uncommon condition with majority of cases resolving within one year after treatment. We report a case of recurrent pyogenic granuloma in a middle aged man who kept on relapsing at different point of time despite treatment with electrocoagulation, cryosurgery and oral methotrexate. The case highlights the unusual presentation of relatively common condition of pyogenic granuloma.

Recurrent pyogenic granuloma (Lobular Capillary Haemangioma) of the eyelid in a breast‐feeding patient

AbstractPyogenic granuloma, also known as lobular capillary haemangioma, is a benign vascular tumour which is commonly found in children, young adults and pregnant women. In pregnant women they are usually found on mucosal surfaces such as the gums and are thought to be related to the hormonal changes associated with gestation. Here we describe a case of a three‐times recurrent pyogenic granuloma in the unusual location of the eyelid in a 34‐year‐old breast‐feeding patient. The patient required three excisional procedures. It was felt that the likely cause of the growth was due to hormonal changes related to the prolonged period of lactation. To date only three other cases have been reported of pyogenic granuloma in the gestational or post‐partum period in the eyelid with this being the first case in a breast‐feeding patient to the best of our knowledge. This case highlights the difficulty in managing these lesions and contributes further evidence towards the hypothesised relationship between the hormonal changes associated with pregnancy, breast‐feeding and this lesion.

A combination treatment of recurrent aggressive pyogenic granuloma

A combination treatment of recurrent aggressive pyogenic granuloma

Subconjunctival Bevacizumab for Recurrent Conjunctival Pyogenic Granuloma

A 45-year-old male presented with a pyogenic granuloma of the bulbar conjunctiva of the left eye following a stick injury. It was a benign friable, hyperplastic, vascular lesion comprised of inflammatory cells and lobular capillary proliferation. The differential diagnosis includes squamous papillomas, hemangiomas, suture granulomas, and ocular surface tumors, such as squamous cell carcinoma and amelanotic melanoma. Conventional treatment includes topical corticosteroids and surgical excision. Treatment of recurrent lesions with cryotherapy, electrocautery, topical antimetabolites, and plaque irradiation has been described. We present a case of recurrent pyogenic granuloma successfully treated with two subconjunctival bevacizumab injections. The patient developed three recurrences after excision at a peripheral hospital after which he was successfully treated with excision and adjuvant subconjunctival bevacizumab 2.5 mg/0.1 ml injection. This case highlights the novel use of bevacizumab for recurrent pyogenic granuloma.

Orocutaneous fistulas of odontogenic origin presenting as a recurrent pyogenic granuloma.

Orocutaneous fistulas, or cutaneous sinuses of odontogenic origin, are uncommon but often misdiagnosed as skin lesions unrelated to dental origin by physicians. Accurate diagnosis and use of correct investigative modalities are important because orocutaneous fistulas are easily confused for skin or bone tumors, osteomyelitis, infected cysts, salivary gland fistulas, and other pathologies. The aim of this study is to present our experience with a patient with orocutaneous fistulas of odontogenic origin presenting as recurrent pyogenic granuloma of the cheek, and to discuss their successful treatment.

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

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.

PYOGENIC GRANULOMA IN A PATIENT WITH PORT-WINE STAIN

Port-wine stain is a congenital capillary malformation that manifests on the mucosa or the skin as pink or red patches. It is possibly part of the clinical signs and symptoms of some syndromes and may also be associated with recurrent pyogenic granulomas (GPs). A 43-year-old female patient with port-wine stain in the chest, neck, and right hemiface with congenital evolution reported excision of an oral lesion without histopathologic diagnosis when she was 13 years old. One year ago, she presented an exophytic, bleeding sessile mass measuring 5 cm, involving the anterior and right posterior region of the mandible, as well as periodontal disease. An excisional biopsy was performed and the diagnosis was GP associated with vascular malformation. The patient is being monitored. Although GP is a reactive lesion with simple treatment, it may be associated with vascular malformations and, in these cases, the standard treatment may present resistance, requiring greater care to prevent recurrences.

Case of lingual osseous choristoma

Introduction: Cervical hyperostosis associated with Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a rare cause of dysphagia. Ossification of ligaments, tendons and joint capsule insertions which can lead to dysphagia, hoarseness, laryngeal stenosis and dyspnoea in cervical hyperostosis. Pharmacological and surgical management have been reported. We present a case of recurrent postoperative pyogenic granuloma requiring laser excision and steroid injection after surgical reduction of oropharyngeal cervical hyperostosis. Case report: A 59-year-old male with dysphagia and foreign body sensation showed clinical and radiological oropharyngeal indentation caused by cervical hyperostosis. He underwent intraoral surgical reduction of upper cervical hyperostosis. Although his oropharyngeal symptoms resolved for 3 weeks, he presented with right posterior pharyngeal haematoma secondary to postoperative infection of pharyngeal mucosa. Histology confirmed reactive vascular response indicative of pyogenic granuloma. Despite surgical removal, intravenous antibiotic and nasogastric feeding for 2 days, he developed recurrent posterior pharyngeal pyogenic granuloma within 6 weeks and required Nd-Yag Laser excision and intramuscular steroid injection. Discussion: Postoperative complications after posterior pharyngeal surgery include infection, haematoma, neck pain, dysphagia and dysphonia. Recurrent pyogenic granuloma after removal of postoperative haematoma secondary to mucosal infection is rare and has not been reported. Immediate surgery may not be necessary as some pyogenic granuloma resolves spontaneously. Conclusion: Recurrent pyogenic granuloma of posterior pharyngeal wall after surgical reduction of cervical hyperostosis is rare. Laser excision with intramucosal steroid injection should be considered in the management of this rare complication.

Recurrent pyogenic granuloma: an update

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>Given the fierce controversy about the nature of pyogenic granulomas, starting with its unfitting name and ending up with its ideal treatment modality, this paper tries to numerically identify some predisposing factors of recurrence.</p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>The literature was initially reviewed and a total of twenty recurrent cases of pyogenic granuloma were contrasted, on one hand, to their initial appearance. On the other hand, all are contrasted to a similar number of normal mucosa using three histochemical stains: Alcian blue, periodic acid-Schiff and Masson’s trichrome.</p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>For all recurrent lesions, all specimens showed myxoid structure histologically even if their initial appearance had possessed a sparse myxoid structure. The age of recurrence has been correlated to the histochemical findings. For the Alcian Blue stain (AB), the value of t-test was 3.808840. The pertaining value of P was 0.000593. The result was significant at P ≤0.05. For the PAS stain, the value of t-test was 3.640327. The value of P was 0.000871. The result was significant at P ≤0.05. In Masson’s trichrome staining, the value of t-test was 3.100816. The value of P was 0.002942. The result was significant at P ≤0.05. Accordingly, all stains showed significant difference in fibrous content in the initial and recurrent lesions. Conversely, the count of both endothelial vessels and inflammatory infiltrates in the recurrent lesions were significantly lower than the primary precursors.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Given that collagen fibers are continually degraded and resynthesized while proteolytic degradation occur outside the cells through the activity of enzymes called matrix metalloproteinases (MMPs), it is suggested that MMPs -positively expressed by PAS reactions- account for the spacing of the fibrous stroma, allowing for reshaping the three dimensional structure of the connective tissue. Myxoid structures are certainly promoting recurrence either via excessive secretion of hyaluronic acids or unknown mechanisms. The undisputed fact is the presence of myxoid structures in all our reported recurrent cases. Both inflammatory cascade and endothelial proliferation have no vital role in the recurrence according to our morphometric results. Finally, PAS stain should give more details in examining PGs than the other recruited counterparts.</p><p class="abstract"><strong><span lang="EN-US">Keywords: </span></strong><span lang="EN-US">Recurrent pyogenic granuloma, PAS stain, Myxoid structures, Etiopathogensis</span></p><p class="keywords"> </p>

RECURRENT PYOGENIC GRAULOMA - A CASE REPORT

AbstractA non-specific, conditioned gingival enlargement, pyogenic granuloma is a reactive lesion that can occur anywhere on mucosa or skin. In the oral cavity, the gingiva is the most frequent site. The recurrence rate is up to 15%. The most common cause of pyogenic granuloma is local irritating factor. This case report describes a recurrent pyogenic granuloma in a 35 year old patient and its successful surgical management.