What is the role of surgery in the treatment of pyogenic granuloma (lobular capillary hemangioma)?

Updated: Feb 21, 2020
  • Author: Joseph C Pierson, MD; Chief Editor: William D James, MD  more...
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Shave, punch, or scalpel excision may be curative if the lesion is completely removed, and it provides a tissue specimen for pathologic confirmation of the diagnosis. Histologic evaluation is vital for any nonhealing lesion. [55] Curettage and electrodesiccation is often successful, either alone, or in combination, [83] and may be performed after shave removal. Among surgical options, full-thickness excision has the lowest rate of recurrence (2.94%). [18]  For digital pyogenic granulomas, a trap technique using a Penrose drain helps minimize bleeding. [85]

A variety of laser modalities have been successfully used. [86, 87, 88, 89, 90] Ligation of the lesion base [91] and cryosurgery [92] have been reported to be effective for pyogenic granulomas.

Many lesions occurring in pregnancy resolve with parturition; because recurrences are higher during pregnancy, some experts recommend postponing removal until after delivery. [93]

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