Review Question - QID 211677

This patient has a pyogenic granuloma (PG), which is a common benign vascular lesion that often presents on the hand.

PGs are typically "beefy red" in color and grow rapidly in the skin or mucosa. PG can grow up to 2cm in length and are histologically defined by collarette enclosing lobules of endothelial cells and luminal structures. PGs more often occur about the head and neck. The differential diagnosis includes melanoma, angiolymphoid hyperplasia, and hemangioma.

Quitkin et al. treated 13 PGs with blunt excision with a hemostat followed by silver nitrate cauterization in an office setting. The authors noted complete resolution in 85% of patients after an average of 1.6 treatments.

Giblin et al. reviewed the demographics and treatment of 408 PGs. The authors noted a slight male predominance and reported that the head and neck were the most common locations. They concluded that recurrence was less likely with surgical excision, although all techniques demonstrated a low recurrence rate.

Figure A is a clinical photo of a pyogenic granuloma.

Incorrect answers:
Answer 1: Epidermal inclusion cysts are benign, slow-growing soft tissue tumors that often occur in the hand, typically after penetrating injury, and are flesh-colored and well-circumscribed.
Answer 2: Giant cell tumors of tendon sheath are benign nodular tumors that are found on the tendon sheath of the hands and feet.
Answer 3: Glomus tumors are a rare benign tumor of the glomus body, often occurring in the subungual region.
Answer 5: An enchondroma is a benign chondrogenic tumor located within the medullary cavity.