A. Epitheloid cells.
B. Cavernous hemangioma.
C. Granulation tissue.
D. Giant cells.
Ans:C. Granulation tissue.
Pyogenic Granuloma is shown in the image.
- Pyogenic granuloma (also known as “granuloma gravidarum”, “lobular capillary hemangioma”, “pregnancy tumor”, and “tumor of pregnancy”) is a vascular lesion that occurs on both mucosa and skin.
- Pyogenic granulomas are misnamed; they are neither infectious nor granulomatous.
- The lesion usually occurs in children and young adults as a solitary, glistening red papule or nodule that is prone to bleeding and ulceration. Pyogenic granulomas typically evolve rapidly over a period of a few weeks, most often on the head, neck, extremities, and upper trunk.It is often found to involve the gums, the skin and nasal septum.
The exact cause is unknown. Implicated factors are:
- Infection (Bartonella, Staph. aureus)
- Drugs (Retinoids, indinavir and OCP)
- Hormonal (pregnancy)
- AV malformation
- Early lesions resemble granulation tissue (numerous capillaries and venules with plump endothelial cells arrayed radially toward the skin surface amidst an edematous stroma containing a mixed inflammatory infiltrate). Often, overlying erosive or ulcerative changes are noted. The matured polypoid lesion exhibits a fibromyxoid stroma separating the lesion into lobules.
- If a clear provoking traumatic factor exists for the pyogenic granuloma (lobular capillary hemangioma) development, remove it.
- Topical and systemic beta-adrenergic receptor antagonists,Topical imiquimod cream ,alitretinoin gel ,
- Injectable sclerosing agents, chemical cauterization with silver nitrate, topical phenol for periungual lesions, photodynamic therapy, intralesional and systemic steroids.
- Shave, punch, or scalpel excision .
- Curettage and electrodesiccation.