Disseminated lobular capillary hemangioma (pyogenic granuloma). A clinicopathologic study of two cases

The eruption of multiple lobular capillary hemangiomas (granulomata pyogenicum) is a previously documented but uncommon phenomenon. Reported cases have featured the recurrence of multiple satellite lesions after surgical removal of, or trauma to, a solitary capillary hemangioma. Sporadic cases of multifocal lesions arising de novo in both previously traumatized and uninjured skin have been described as well. We describe herein two unusual patients with disseminated lobular capillary hemangioma. One patient developed skin nodules in several sites, including the mouth, knee, thumb, and foot, after surgical removal of a solitary oculocutaneous neoplasm. The second patient had more than 700 skin lesions, distributed over the entire body. Unlike those in most previously reported examples of this condition, these two patients were elderly. Both were misdiagnosed clinically as having malignant vascular neoplasms, but the behavior of the lesions was benign, despite conservative surgical excisions in one patient and relative lack of therapeutic intervention in the other.