Pyogenic Granuloma

Also known as ‘Granuloma Telangiectaticum’, pyogenic granuloma is a type of skin infection wherein patients suffer from the formation of bumpy reddish lumps. These appear like raw meat that has been chopped into pieces, or like raspberry. It is a harmless condition, but occasionally it can result in excessive bleeding and discomfort.

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Medical experts consider pyogenic granuloma as an oral condition which arises due to overgrowth of tissues resulting from irritation, hormonal alterations, or physical injury. These then affect the nasal pathways and the skin, and on occasions other body areas such as the thighs.

Pyogenicgranuloma was discovered by two French surgeons, Dor and Poncet, in the year 1987. Upon discovery they named it ‘botryomycosis hominis’. When studied, medical students will realize that the term ‘pyogenic granuloma’ is not ideal for the disease as the anomaly is not an original form of granuloma. Capillary hemangioma of the lobular subtype is what causes the bleeding. Also, it cannot be pyogenic because the original forms are typically painless and non-infectious.

Symptoms

A few common signs and symptoms of this skin infection are listed below:

  • Pyogenic granuloma lesions are generally smooth and tend to grow rapidly. They may experience bleeding even with minor or nil trauma. Lesions occurring in regions prone to irritation can be painful, otherwise they typically cause pain for a short period.
  • The colors tend to vary constantly; they can alternate between being pinkish, purplish, or reddish. Newly developed pyogenic granuloma lesions contain a lot of blood vessels and hence are mostly reddish in color. With the passage of time they turn a shade of pink.
  • The lesions can differ in size, measuring anywhere between 2 mm and 2 cm diametrically. Sometimes, it can also grow as large as 5 cm.
  • Common areas that are affected include the tongue, lips, and insides of the cheeks.
  • The gingival also tends to get affected, leading to the formation of two gingival diseases, i.e., peripheral ossifying fibroma and peripheral giant cell granuloma.
  • The surface of pyogenic granuloma lesions may experience ulceration or inflammation.
  • Women may develop the lesions during the first month of pregnancy. It tends to aggravate and spread till the 7th month. The condition typically occurs in anterior part of the nasal septum in expectant women, resulting in chronic nasal bleeding.
  • In rare instances, mild injuries can result in corneal lesions, or affect the conjunctiva or connective tissues in the eye. Such lesions are appear similar to those affecting other parts of the body.

Causes

Doctors are not aware about the exact cause of pyogenic granuloma. Some of the risk factors which can increase the susceptibility towards developing  infections are listed below:

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  • One of the most common causes of pyogenic granuloma lesions is infection by the staphylococccus aureus bacterium.
  • Although yet to be medically proved, viral infections are also thought to be causative factors.
  • Minor injuries or physical trauma such as a needle or pin prick.
  • On occasions, defects or abnormalities in varied blood vessels can also give rise to pyogenic granuloma lesions in that affected region of the body.
  • Adolescents, children, and women are more vulnerable than men.
  • Because of hormonal causes, pregnant women may also get affected. The risk is however rare and often occurs due to previous use of birth control pills.
  • Poor oral hygiene or elevated stress can contribute towards formation of pyogenic granuloma lesions.
  • The skin anomalies can also form due to use of medications like protease inhibitors or systemic retinoids.

Treatment

If pyogenic granuloma lesions are caused due to intake of certain medicines, then patients need to consult a doctor for alternative drugs. The lesions will vanish after stopping the use of the culprit drug.

In expectant women, pyogenic granuloma lesions fade away on their own after childbirth. Pregnant women are therefore suggested to wait it out rather than opt for treatment as it can result in pregnancy complications.

Besides the above mentioned two scenarios, pyogenic granuloma can be treated in the below listed ways:

  • Laser therapy can be used to burn the lesions and thus destroy them. Pulse dye laser treatment option is typically used for contracting tiny lesions.
  • The most effective method to eliminate pyogenic granuloma in children is via a procedure called imiquimod.
  • Doctors may also opt for another medical procedure called curettage and cauterization. The treatment involves scrapping-off of the anomalous skin with the help of a sharp medical tool called a curette. Later, the blood vessels that supply blood to the lesions are cauterized to decrease the risk of recurrences.
  • Cryosurgery is another effective method, wherein liquid nitrogen is used to freeze and destroy the lesions.
  • Pyogenic granuloma lesions thrive on the ample supply of blood by the vessels occurring deep within the skin. Surgical excision of the entire region is therefore often recommended by doctors. In this method, the affected area is cut out, and then sutured and bandaged to prevent infections.
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