Lobular capillary haemangioma (granuloma pyogenicum)

Last Updated: 2024-01-25

Author(s): Navarini A.

ICD11: 2F26

Poncet and Dor 1897

Epulis teleangiectatica, granuloma teleangiectaticum, granuloma pediculatum, eruptive haemangioma

Benign vascular tumour, typically occurring after minor trauma.

Epulis gravidarum on the gingiva in pregnancy is quite typical, spontaneous regression after birth.
Nasal piercings can trigger intranasal granuloma pyogenicum
Oral anticontraceptives, oral retinoids, protease inhibitors can trigger it
S. aureus is often detectable.

Granuloma pyogenicum vulgaris
Granuloma pyogenicum subcutaneous et intravasale (histological subtype)
Granuloma pyogenicum disseminatum
Granuloma pyogenicum with satellite nodules (in children and adolescents, recurrence with satellites in the periphery, benign)
Bacterial nailfold angiomatosis i.S. reactive granulation tissue in unguis incarnatus.

Rapid development of an erythematous nodule, slightly constricted base. Size from about 3mm to 30mm.
Scarcely any pain.
Surface bleeding (patch sign!), oozing or erosive.
A high bleeding tendency is found. Secondary ulceration.
No spontaneous healing. High recurrence rate.

Typical clinic.

Hands and feet, head and neck region, mouth, gingiva, pharynx, nose.

Mostly erosive and inflamed, arborising vascular tumour, lobular structure. CD31+. Multiple convolutions of densely packed capillaries between connective tissue septa. Epithelial collerettes laterally. Endothelial mitotic activity objectifiable with Ki-67+.

Recurrence with incomplete ablation.
Anemia with prolonged bleeding.
Oral pyogenic granulomas can lead to bone loss.

Discontinue inducing drugs
Improve oral hygiene, remove dental trauma and sharp, mucosa-injuring edges
Remove piercings