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Pyogenic granuloma - the quest for optimum treatment: audit of treatment of 408 cases
A V Giblin1, A J P Clover, A Athanassopoulos
1Department of Plastic and Reconstructive Surgery, Stoke Mandeville Hospital, Mandeville Road, Aylesbury, Buckinghamshire HP21 8AL, UK. drgiblin@yahoo.co.uk
Abstract:
Pyogenic granuloma is a common, acquired, benign vascular lesion of skin and mucous membranes which may occasionally present intravascularly or subcutaneously. Pyogenic granuloma occur in all age groups and although they may eventually regress, removal of unsightly, bleeding or uncomfortably positioned lesions is usually sought before this takes place. This is a retrospective study of 408 cases of pyogenic granuloma that were analysed by the Stoke Mandeville Histopathology laboratory between 1994 and 2004. This study was carried out to review the sex, age and anatomic distribution of the lesions and to assess the most successful form of treatment on the basis of recurrence risk and other measures such as aesthetic result, acceptability and appropriateness of the procedure with respect to the patient. There was a slight male preponderance especially among children. The exception to this was lesions on mucous membranes, which were more common in women. Head and neck was the most common anatomical location, in particular the cheek and intraoral locations. Fewest recurrences were noted following excision and direct closure although all techniques investigated showed an acceptably low recurrence rate. Whatever technique is used it must yield material for histopathological analysis to ensure the exclusion of differential diagnoses.
Insights
Pyogenic granuloma, a common skin lesion, shows varied distribution by sex and age. Excision with direct closure appears to be the most successful treatment, minimizing recurrence risk.
Area of Science:
- Dermatology
- Histopathology
- Surgical Pathology
Background:
- Pyogenic granuloma is a frequent, benign vascular skin and mucous membrane lesion.
- Lesions may regress but are often removed due to cosmetic or functional concerns.
Purpose of the Study:
- To review the demographic and anatomic distribution of pyogenic granuloma.
- To assess treatment success, focusing on recurrence rates and patient outcomes.
Main Methods:
- Retrospective analysis of 408 pyogenic granuloma cases from 1994-2004.
- Evaluation of patient sex, age, lesion location, and treatment outcomes.
Main Results:
- A slight male predominance was observed, except for mucous membrane lesions which were more common in women.
- Head and neck, particularly cheek and intraoral sites, were the most frequent locations.
- Excision with direct closure demonstrated the lowest recurrence rates among investigated treatments.
Conclusions:
- Pyogenic granuloma exhibits distinct demographic and anatomic patterns.
- While various treatments are acceptable, surgical excision with direct closure offers the lowest recurrence risk.
- Histopathological analysis is crucial for accurate diagnosis and to rule out other conditions.
