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Capillary hemangioma / pyogenic granuloma

Published: September 18, 2026Updated: September 18, 2026

Important: Informational content intended for healthcare professionals. It does not replace clinical evaluation or establish a doctor-patient relationship.

Overview

  • Definition and synonyms
    • Acquired benign vascular tumor, characterized by a lobular proliferation of capillaries in the skin and mucous membranes → today the term lobular capillary hemangioma (LCH) is preferred; “pyogenic granuloma” is a “misnomer” (there is no pus or true granuloma). Jafarzadeh 2006 , Wollina 2017
    • Common synonyms: pyogenic granuloma, telangiectatic granuloma, lobular capillary hemangioma , «pregnancy tumor» / granuloma gravidarum (gingival form in pregnant women). Jafarzadeh 2006
  • History
    • Lesions initially described by Poncet and Dor in 1897 as botryomycosis hominis . Jafarzadeh 2006
    • The term “pyogenic granuloma / granuloma pyogenicum” was coined by Hartzell in 1904; since then it has also been known as Crocker–Hartzell disease . Jafarzadeh 2006
  • Epidemiology
  • Age:
    • Pediatrics: In a series of 178 children (mean age 6.7 years), 42% appeared within the first 5 years of life. Patrice 1991
    • Oral lesions: peak in the 2nd–3rd decade . Jafarzadeh 2006
  • Sex:
    • Slight overall female predominance; more marked in oral location (up to a 1:2.6 M:F ratio). Saravana 2009 , Kadeh 2015
  • Frequency in oral pathology:
    • In oral biopsy series, pyogenic granuloma represents ~2–5% of all lesions and is one of the most common reactive hyperplasias. Saravana 2009 , Kadeh 2015 , Aly 2022
    • Predilection for gingival involvement (≈60–80% of oral cases) and for head and neck involvement on the skin. Patrice 1991 , Saravana 2009
  • ICD Codes
    • ICD-10:
      • L98.0 – Pyogenic granuloma / pediculatum granuloma of the skin.
      • K13.4/K13.5 – Granulomatous lesions of the oral mucosa (includes oral pyogenic granuloma).
    • ICD-11:
      • 2F26 – Lobular capillary haemangioma (granuloma pyogenicum) (generic code for skin and mucous membranes).
  • Diagnostic checklist (quick)
    • Essential clinic
      • Reddish-violet exophytic papule/nodule, <2 cm, with rapid growth (weeks).
      • Easy bleeding with minimal trauma.
      • Typical location (skin of head/neck, extremities, periungual, gingiva/lip).
      • Review of possible factors: local trauma, chronic irritation, pregnancy, contraceptives, systemic drugs (retinoids, taxanes, EGFR/VEGF/BRAF inhibitors, antiretrovirals, biologics).
    • Additional exploration
      • Dermatoscopy (if available): homogeneous reddish area + white collarette.
      • Assess for warning signs (clinical atypia, large size, deep, irregular ulceration, elderly patient).
    • Laboratory/office studies
      • Only if clinically indicated: blood count/coagulation (anemia or significant bleeding).
      • Imaging (ultrasound/MRI/endoscopy) if the lesion is deep, subcutaneous, or visceral.
    • Biopsy
      • Prefer complete excision (skin/mucosa) including base, whenever feasible.
      • In typical small lesions → shaving + curettage + electrocoagulation, assuming a higher risk of recurrence.
      • Send in 10% formalin with good orientation and complete clinical data (location, evolution, treatments and associated drugs).

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