Pyogenic Granuloma with Onychomadesis following Plastic Cast Immobilization: A Case Report in a Pediatric Patient

Pyogenic granuloma development following plaster cast immobilization is rare, with only 17 reported cases previously.

Here, we present a case of the youngest patient to date, an 11-year-old male, who developed a pyogenic granuloma on his left thumbnail after cast immobilization for a left wrist and elbow fracture. His fracture was complicated by wound infection, ulnar nerve injury, and avascular necrosis. Following cast removal, a pyogenic granuloma developed on his left thumbnail that was recalcitrant to treatment with timolol, and surgical resection was recommended. Additionally, he had onychomadesis of all nails on his left hand.

This case highlights an association between pyogenic granuloma development and plaster cast immobilization in pediatric patients.