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

Updated: Jun 04, 2018
  • Author: Joseph C Pierson, MD; Chief Editor: William D James, MD  more...
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Answer

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. [51] Curettage and electrodesiccation is often successful, either alone, or in combination, [73] and may be performed after shave removal. Among surgical options, full-thickness excision has the lowest rate of recurrence (2.94%). [17]  For large or difficult surgical areas, transarterial embolization may be an option. [74]

A variety of laser modalities have been successfully used. [75, 76, 77] Ligation of the lesion base [78] and cryosurgery [79] 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. [80]


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