Pyogenic granuloma-like Spitz naevus in paediatric patients: a case series

Pyogenic granuloma is a benign vascular lesion. The differential diagnosis encompasses both malignant and benign conditions. While several modalities are available for its management, only surgical options enable a histopathological diagnosis, which is crucial to rule out clinical mimickers.

To examine paediatric patients with pyogenicgranuloma-like Spitz naevus and emphasize the importance of tissue sampling for diagnostic accuracy and optimal care.

A retrospective single-centre study of paediatric patients with lesions clinically diagnosed as pyogenic granuloma ultimately diagnosed as Spitz naevus following a histopathological evaluation between January 2018 and December 2023.

Of 84 paediatric patients with clinically suspected pyogenic granuloma who underwent biopsy, 6 (7.1%) were diagnosed with Spitz naevus. All lesions had involved surgical margins requiring re-excision, which achieved clear margins with no recurrences during an average follow-up of 27.5 months. The mean age of the patients at onset was 2 years 4 months. Lesions were evenly distributed between the face and extremities.

The broad differential diagnosis of pyogenic granuloma highlights the risk of misdiagnosis when solely relying on a clinical diagnosis. Although nonsurgical treatments are convenient, the high clinicopathological discrepancy rate further underscores the need for histopathological confirmation.