Pyogenic Granulomas

ByDenise M. Aaron, MD, Dartmouth Geisel School of Medicine
Reviewed/Revised Sept 2023
View Patient Education

Pyogenic granulomas are fleshy, moist or crusty, usually scarlet vascular nodules composed of proliferating capillaries in an edematous stroma.

The lesion, composed of vascular tissue, is neither of bacterial origin nor a true granuloma. It develops rapidly, often at the site of recent injury (although injury may not be recalled), typically grows no larger than 2 cm in diameter, and probably represents a vascular and fibrous response to injury. There is no sex or age predilection.

The overlying epidermis is thin, and the lesion tends to be friable, bleeds easily, and does not blanch on pressure. The base may be pedunculated and surrounded by a collarette of epidermis.

During pregnancy, pyogenic granulomas may become large and exuberant (called gingival pregnancy tumors or telangiectatic epulis).

Examples of Pyogenic Granulomas
Pyogenic Granuloma (Palm)
Pyogenic Granuloma (Palm)

A pyogenic granuloma manifests as a scarlet nodule composed of proliferating capillaries in an edematous stroma. The lesion tends to be friable and bleeds easily. It probably represents a vascular and fibrous response to injury.

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Image provided by Thomas Habif, MD.

Pyogenic Granuloma (Lip)
Pyogenic Granuloma (Lip)

This photo shows an erythematous rounded lesion consistent with pyogenic granuloma.

DR P. MARAZZI/SCIENCE PHOTO LIBRARY

Pyogenic Granuloma (Shoulder)
Pyogenic Granuloma (Shoulder)

This image shows recurrent, fleshy, scarlet, vascular nodules of pyogenic granulomas.

Image courtesy of Karen McKoy, MD.

Pyogenic Granuloma (Nail)
Pyogenic Granuloma (Nail)

Pyogenic granuloma is a benign growth.

DR P. MARAZZI/SCIENCE PHOTO LIBRARY

Diagnosis of Pyogenic Granulomas

  • Biopsy

Diagnosis of pyogenic granuloma involves biopsy and histologic examination. Histologic analysis is required for all removed tissue because these lesions occasionally resemble and must be differentiated from melanomas or other malignant tumors.

Treatment of Pyogenic Granulomas

  • Excision or curettage and electrodesiccation

Treatment of pyogenic granulomas consists of removal by excision or curettage and electrodesiccation, but the lesions may recur.

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