A Case of Postoperative Pyogenic Granuloma at the Middle Turbinate

이재훈 대한비과학회 2009 Journal of rhinology Vol.16 No.1

Pyogenic granuloma is a benign, vascular lesion of unknown etiology that occurs uncommonly in the nose. Trauma and hormonal factors are considered major causes of pyogenic granuloma. Nasal packing is a very common procedure in rhinology and this procedure might be related to the development of pyogenic granulomas. The most frequent symptoms of pyogenic granulomas are epistaxis and nasal obstruction. This report represents the second case of pyogenic granuloma occurring at the middle turbinate in the English literature and it may have arisen secondary to postoperative nasal packing or intraoperative trauma. Pyogenic granuloma is a benign, vascular lesion of unknown etiology that occurs uncommonly in the nose. Trauma and hormonal factors are considered major causes of pyogenic granuloma. Nasal packing is a very common procedure in rhinology and this procedure might be related to the development of pyogenic granulomas. The most frequent symptoms of pyogenic granulomas are epistaxis and nasal obstruction. This report represents the second case of pyogenic granuloma occurring at the middle turbinate in the English literature and it may have arisen secondary to postoperative nasal packing or intraoperative trauma.

Multiple pyogenic granulomas over previous treated area in a postmenopausal woman on hormone replacement therapy

( Jung Woo Lee ),( Geo Han ),( Hae Jun Song ),( Chil Hwan Oh ),( Jiehyun Jeon ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Pyogenic granuloma is a benign vascular tumor that is common in children but may occur at any age. Although the lesion usually presents as a solitary papule, the development of multiple satellite pyogenic granulomas has been rarely reported. A 53-year-old woman presented with easily bleeding sessile papule and surrounding reddish papules on scalp lasted for a year. The primary lesion had been treated by electrodessication 1.5 years ago but the lesion has been recurred with new multiple satellites. She was treated with hormone replacement therapy to improve menopausal symptoms for 3 years. The histological findings of the primary and satellite lesions showed many dilated capillaries and epidermal collarette which are consistent with pyogenic granuloma. Two consecutive excisions for remnants were done and all the specimens confirmed the diagnosis of pyogenic granuloma. Multiple pyogenic granulomas are known to develop around the recently treated areas and one of hypotheses proposes releasing of various endogenous substances including angiogenic factors by trauma. Furthermore, frequent development of pyogenic granuloma during pregnancy implies the hormonal factors as a major role. Therefore, postmenopausal women treated with hormonal therapy may be at increased risk for pyogenic granuloma. We report herein a rare case of multiple pyogenic granulomas over previous treated area, in a postmenopausal woman on hormone replacement therapy.

Immunohistochemical Evaluation of Angiogenesis Related Markers in Pyogenic Granuloma of Gingiva

Seyedmajidi, Maryam,Shafaee, Shahryar,Hashemipour, Golnarsadat,Bijani, Ali,Ehsani, Hodis Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.17

Background: Pyogenic granuloma is a common non-neoplastic connective tissue proliferation. ICAM-1 and VCAM-1 are vascular adhesion molecules and CD34 is a marker for evaluation of angiogenesis. The purpose of this study was to compare the immunohistochemical expression of ICAM-1, VCAM-1 & CD34 in oral pyogenic granuloma and normal gingiva. Materials and Methods: This study was performed on thirty five formalin-fixed, paraffin embedded samples of gingival pyogenic granuloma. Also we used thirty five paraffined blocks of normal gingiva as control group which were taken from crown lengthening surgery. We employed immunohistochemistry staining for our prepared microscopic slides using monoclonal mouse anti-human antibodies against ICAM-1 (CD54), VCAM-1 (CD106) and CD34. Slides were examined under light microscope and then the mean amount of stained vessels also known as microvascular density (MVD) in highly vascularized areas (hot spots) was measured. Paired t-test and repeated measures ANOVA were used to compare the difference between quantitative variables and Chi-square test for qualitative variables in different groups. Pearson correlation coefficient was used to compare relations between quantitative variables. P<0.05 was considered significant. Results: The mean of MVD for ICAM-1, VCAM-1 and CD34 was significantly higher in pyogenic granuloma than normal gingiva (p<0.001 & p<0.001 & p<0.001, respectively). Expression of CD34 in pyogenic granuloma was significantly higher than ICAM-1 and VCAM-1 (P<0.001). Besides, expression of ICAM-1 in normal gingiva, was significantly lower than two other markers (p<0.001). Conclusions: Regarding the results, it seems that ICAM-1, VCAM-1 and CD34 are useful biomarkers in evaluation of vascular and inflammatory lesions such as gingival pyogenic granuloma and the results indicate the role of these biomarkers in pathogenesis of oral pyogenic granuloma.

Esophageal Pyogenic Granuloma: Endosonographic Findings and Endoscopic Treatments

성형규,김광하,송근암,김지혜,오민영,최정천,고정희,박창준 대한소화기내시경학회 2013 Clinical Endoscopy Vol.46 No.1

Pyogenic granuloma is a benign inflammatory vascular lesion, mainly found in the skin and oral mucosa. A few cases of pyogenic granuloma in the gastrointestinal tract have been reported, and the esophagus was the main site in these cases. These patients were diagnosed with pyogenic granuloma after they underwent upper endoscopy and biopsy. Endoscopic resection is a favorable treatment option for esophageal pyogenic granuloma. Recently, we observed characteristic endosonographic findings in two cases with esophageal pyogenic granuloma, which were then treated successfully by endoscopic resection.

화농성 육아종의 임상 및 병리조직학적 고찰

박상훈 ( Sang Hoon Park ),강유석 ( Yoo Seok Kang ),이운하 ( Un Ha Lee ),박현수 ( Hyun Su Park ),장상재 ( Sang Jai Jang ) 대한피부과학회 2011 大韓皮膚科學會誌 Vol.49 No.8

Background: Pyogenic granuloma is a common vascular neoplasm of the skin and mucous membranes. However, few comprehensive studies are available on the clinical and histopathological characteristics of pyogenic granuloma. Objective: To analyze the clinical and histopathological characteristics of pyogenic granuloma. Methods: Patients with pyogenic granuloma diagnosed clinically and histopathologically were reviewed retrospectively. Results: Fifty patients (17 males and 33 females) were enrolled, and the mean age of onset was 33.6 years old. The mean lesion size was 6.7 mm. Forty-eight patients had a solitary lesion, whereas two patients had multiple lesions on the skin and mucosa. The most common area for lesions was the head and neck followed by the hands, trunk, and lower extremities. Patient complained of easy bleeding, pain, tenderness, and pruritus. Dermoscopic findings of nine lesions showed patterns of a reddish homogenous area, white scaly collarette, white rail lines, and a hemorrhagic crust. Histopathological findings of all biopsy cases showed a lobular pattern of angiomatous tissue with numerous congested capillaries, a flattened epidermis, a well-formed epidermal collarette, and CD34-positive endothelial cells. Various treatment modalities including surgery and laser have been used, but lesions recurred following a single laser treatment with a pulsed dye laser or long-pulsed Nd:YAG laser. Conclusion: A correlation between clinicopathological and dermoscopic findings was useful for the differential diagnosis of other diseases mimicking pyogenic granuloma and to detect recurrence after treatment. Laser treatments were less invasive therapy, but the recurrence rate was higher than that of other surgical modalities when used alone. Additional prospective studies are needed to determine the effectiveness of the various treatment modalities. (Korean J Dermatol 2011;49(8):690∼698)

화농성 육아종에 대한 5% Imiquimod 크림의 치료 효과

김세희 ( Se Hee Kim ),윤문수 ( Moon Soo Yoon ),김두한 ( Doo Hwan Kim ) 대한피부과학회 2006 대한피부과학회지 Vol.44 No.9

Background: Conventional interventions for pyogenic granuloma include excision, electrodessication and curettage, cryotherapy, and laser ablation, all of which can be associated with local tissue destruction, scarring, and recurrence in some cases. Although imiquimod is commonly regarded as an immune response modifier, it also induces antiangiogenic factors such as tissue inhibition of matrix metalloproteinase-1 (TIMP-1), IL-12 and increases apoptosis in vascular tumors. Objective: To investigate the therapeutic efficacy of imiquimod on pyogenic granuloma. Methods: Twelve patients with pyogenic granuloma were treated with 5% imiquimod cream every night for up to 8 weeks. Therapeutic efficacy, side effects and patient`s satisfaction scale were evaluated. Results: The onset time of effects ranged from 1 to 11 days (mean: 4.6 days). The clearance rate at 8 weeks after treatment was 83.3% and the mean time for clearance was 3.6 weeks. 3 of 12 (25%) patients experienced local pain, erosion and hemorraging as adverse events. However, there has been no recurrence, scarring, or hypopig-mentation after more than 8 months of follow-up. Conclusion: Imiquimod may represent a safe, simple and effective alternative in the management of pyogenic granuloma. This therapeutic modality may be of particular benefit in children and patients whose lesions are on the face. (Korean J Dermatol 2006;44(9):1078~1083)

Bowen`s disease mimicking pyogenic granuloma

( Mingyul Jo ),( Jisook Yoo ),( Joon Won Huh ),( Min Soo Kim ),( Kwang Hyun Choi ),( Hyang Joon Park ),( Mihn Sook Jue ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

A 71-year-old male came to our clinic complaining of a painful solitary erythematous pedunculated nodule on the left popliteal area. It had a clinical presentation similar to that of a pyogenic granuloma which is usually a solitary, sessile or pedunculated, friable papule. The patient said that the lesion had grown up to 1.0 x 0.4 cm in size since 3 years ago and occasionally bled. Skin biopsy taken from the lesion showed atypical keratinocytes disorderly arranged throughout the epidermis. Non-specific proliferations and dilatations of vessels were noted in the upper dermis. From these findings the lesion was diagnosed as Bowen’s disease and surgically removed and the patient is under observation without recurrence. Occasionally, skin malignancy presents atypical clinical manifestation and mimics various other cutaneous skin diseases. In this situation, diagnosis and proper management would be delayed. There are 19 reported cases of skin malignancy mimicking pyogenic granuloma: cutaneous metastasis (6), melanoma (6), Kaposi’s sarcoma(3), Lymphoma(2), Hidradenocarcinoma(1), basal cell carcinoma(1). While 19 cases of other skin malignancy mimicking pyogenic granuloma have been reported, there was no reported case of Bowen’s disease. So we herein report a first case of Bowen’s disease mimicking pyogenic granuloma.

Peripheral odontogenic fibroma: A rare benign gingival tumor and compared with pyogenic granuloma

( Jae-hong Lee ),( Seong-nyum Jeong ) 조선대학교 치의학연구원(구 조선대학교 구강생물학연구소) 2018 Oral Biology Research (Oral Biol Res) Vol.42 No.3

Peripheral odontogenic fibroma (POF, WHO-type) is a relatively rare benign tumor which shows sessile, firm, and exophytic gingival enlargement. Microscopically, a POF is a gingival lesion consisting of scattered and multiple islands of odontogenic epithelial strands and keratinized stratified squamous epithelium with long and thin rete pegs underlying fibrocellular connective tissue. A mature lesion of POF is clinically difficult to distinguish from pyogenic granuloma, due to their similar shapes and colors, and the fact that pyogenic granuloma is a frequently-occurring disease. Therefore, we report a case of POF in a 37-year-old female and compare it with pyogenic granuloma.

Pyogenic granuloma-like lesions during isotretinoin therapy treated by electrocauterization surgery in Republic of Korea: a case report

Hye Sung Han,Sun Young Choi,Young Gue Koh,Kapsok Li 대한의학레이저학회 2023 MEDICAL LASERS Vol.12 No.2

Isotretinoin is highly effective in the treatment of severe cystic and conglobate acne. On the other hand, its use has been associated with various side effects, including cheilitis, conjunctivitis, xerosis, epistaxis, and pruritus. The development of pyogenic granuloma-like lesions has been reported as a rare adverse effect of oral isotretinoin therapy. This paper reports a case of isotretinoin-induced pyogenic granuloma-like lesions treated successfully with electrocauterization surgery. This case illustrates the appearance of typical lesions and the clinical course of isotretinoin-induced pyogenic granuloma-like lesions and highlights the need for dermatologists to be aware of the adverse events that may occur during treatment with isotretinoin and that electrocauterization surgery may be a useful treatment option.

모반을 실로 묶어 발생된 화농성 육아종양 병변 1예

신봉석,정병수,최규철 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

Pyogenic granuloma is a benign vascular, inflammatory proliferation that appears following minor trauma in children and young adults. The exact pathogenesis of pyogenic granuloma is unknown, but its formation is closely related to minor trauma, chronic irritation, and hormonal influences. A 52-year old woman visited us with a protruding nodule on the right zygoma area. The nodule was pedunculatedby trauma of tied up nevus. Based on the histological finding, we diagnosed post-traumatic pyogenic granuloma like lesion developed within melanocytic nevus.