Summary

Pyogenic granuloma (PG) is a common, benign vascular tumour that presents as a rapidly growing, friable, red nodule that bleeds easily. Despite its name, it is neither pyogenic (no pus) nor a true granuloma — the correct histological term is lobular capillary haemangioma. It typically follows minor trauma and is common in children, young adults, and pregnant women (pregnancy tumour of the gingiva). Common sites include fingers, face, lips, and gums. The main concern is the clinical resemblance to amelanotic melanoma, so histological confirmation is essential. Treatment is curettage and cauterisation; recurrence is common if incompletely excised.

Key Facts

• Pathology: Lobular capillary haemangioma (NOT pyogenic or granuloma)
• Appearance: Bright red, friable nodule with collarette of scale; Bleeds easily
• Sites: Fingers, Face, Lips, Gums (pregnancy)
• Triggers: Minor trauma, Pregnancy
• Treatment: Curettage + Cautery; Send for histology
• Rule Out: Amelanotic melanoma

Clinical Pearls

"Not Pyogenic, Not Granuloma": The name is a misnomer — there is no infection or granulomatous inflammation.

"Bleeds Like Crazy": Profuse bleeding with minor trauma is characteristic.

"Collar of Scale": A collarette of epithelium at the base is a classic finding.

"Always Histology": Never assume a rapidly growing nodule is benign — always send for histology to exclude amelanotic melanoma.

Inspection

• Red, dome-shaped nodule
• Glistening surface
• Collarette of scale at base
• May be pedunculated (on a stalk)

Palpation

• Soft, friable
• Bleeds easily on touch

With Complete Excision

• Cure in most cases

Recurrence

• 10-40% if incompletely removed
• Satellitosis rare but troublesome

Pregnancy-Related

• Often resolves spontaneously after delivery

Key Resources

1. BAD: Patient Information on Pyogenic Granuloma

Key Evidence

Curettage and Cautery

• Preferred method; Low recurrence with adequate cauterisation

What is a Pyogenic Granuloma?

A pyogenic granuloma is a small, red, raised lump on the skin that grows quickly and bleeds very easily. Despite its name, it's not caused by an infection.

What Causes It?

Often, it appears after a minor injury. It's also common during pregnancy (especially on the gums).

Is It Serious?

It's not cancer, but it should be removed and checked under a microscope (histology) to make sure it's not something more serious like an unusual type of skin cancer.

How is It Treated?

• Scraped off (curettage) and burned (cauterised) to stop bleeding and prevent it coming back
• The removed tissue is sent for testing

Will It Come Back?

Sometimes, especially if not fully removed. Your doctor will advise if this happens.