Treatment options for cutaneous pyogenic granulomas: a review

Pyogenic granuloma (PG) is a common benign vascular proliferation that commonly occurs on the skin. Various treatment options exist in the literature with no clear consensus. Our objective was to review the literature associated with PGs and their management, and based on recurrence rates, suggest management options. A retrospective literature review examining the treatment of cutaneous PG and their associated recurrence rates was conducted. A total of 34 manuscripts were included in our review; with 1162 PGs managed using 19 different treatment modalities with 53 recurrences observed. Among the surgical management options, surgical excision offers the lowest overall recurrence rates (2.94%). Of the medical treatments, cryotherapy offered the lowest overall recurrence rate (1.62%). We concluded that surgical excision and primary closure should be the treatment of choice for small cutaneous PGs in non-cosmetically sensitive areas; however if non-surgical management is undertaken, cauterization with silver nitrate should be the first line treatment. When comparing recurrence rates of surgical excision vs. cauterization, we found no statistical difference between the two (p-value 0.426).