Pyogenic granuloma is a benign skin tumor that develops from embryonic blood vessel cells. It often grows very quickly, but always remains limited. It often develops during pregnancy as a pregnancy tumor in the oral cavity.
What is pyogenic granuloma?
The pyogenic granuloma represents a benign proliferation of vascular cells in the skin. The growth is often misinterpreted as a malignant degeneration. However, the tumor remains sharply demarcated and does not form metastases. Even without treatment, the prognosis is good. The tumor appears red and has a raspberry-like appearance. Colloquially, the pyogenic granuloma is also referred to as a blood sponge. See sportingology for Meaning of Benign Prostatic Hyperplasia in English.
The reddish appearance is caused by the large number of newly formed blood vessels. Since the growths affect vascular cells, the term pyogenic granuloma is actually scientifically incorrect. The term “pyogenic” means producing pus. A granuloma usually affects immune cells. Since neither pus is formed here nor immune cells are affected, the term pyogenic granuloma is based on a misnomer. Therefore, the tumor is also referred to by many authors as a lobular capillary hemangioma.
The disease therefore belongs to the group of hemangiomas. Men and women of all ages can be affected. In light-skinned people, the blood sponge occurs in up to 86.4 percent. Very often it occurs in the oral cavity during pregnancy.
The causes of a pyogenic granuloma have not yet been clearly clarified. A hemangioma is an embryonic tumor that develops through proliferation of embryonic cells. Usually, hemangiomas mainly affect children and young people. However, pyogenic granulomas in particular can also occur in all age groups. It was found that the embryonic vascular wall cells behave like the tissue of the placenta. Your growth is self-limiting.
It is not yet known which pathomechanisms lead to the formation of pyogenic granuloma. In any case, their increased occurrence during pregnancy was established. The so-called pregnancy tumor develops exclusively in the oral cavity. It occurs especially in patients who have inflammatory processes in the gums at the same time. The interaction of pregnancy hormones and infectious processes in the oral cavity is suspected. After pregnancy, the pregnancy tumors regress spontaneously.
Pyogenic granulomas can also develop outside of pregnancy in both men and women. Often their formation is preceded by traumatic injuries, hormonal changes or the use of certain drugs. Even small insect bites can trigger a blood sponge. Even with second-degree burns, pyogenic granulomas often develop years later at the affected area. Malformations of blood vessels such as port-wine stains also promote the development of haemangiomas.
Symptoms, Ailments & Signs
The pyogenic granuloma appears as a small red nodule that quickly spreads by growing. The tumors can reach a diameter of 10 to 30 millimeters. Growth is limited. The demarcation from the rest of the tissue also remains sharp. Usually only a single tumor is observed. In rare cases, multiple satellite tumors occur. The pyogenic granuloma has a tendency to bleed and ooze. The surface becomes encrusted.
Later there is a tendency to form ulcers. However, there is never any pain. The tumor is usually found in the head and neck area and on the mucous membranes of the nose and mouth. Lips, scalp, face and tongue are often affected. Blood sponges can also appear on the palms of the hands, the toes or even the penis. The pregnancy tumor, on the other hand, is only found in the oral cavity. In rare cases, internal organs such as the liver, intestines, esophagus or stomach are also affected. Once a pyogenic granuloma has formed, it usually does not go away on its own.
Here, too, the pregnancy tumor is an exception. In the case of a pyogenic granuloma, no complications are usually to be expected. The prognosis is good. There is no degeneration. In extreme cases, however, degeneration of the nasal skeleton and paranasal sinuses can occur.
Diagnosis & course of disease
A pyogenic granuloma is very easy to diagnose visually. However, it is often difficult to differentiate from dangerous diseases such as malignant melanoma, hemangiosarcoma or squamous cell carcinoma. However, corresponding histological examinations then provide certainty.
In about half of patients, a pyogenic granuloma grows back after removal. This can lead to sensitive nerve damage and skin changes in the area around the tumor. The formation of scars is also possible. If the granuloma is left untreated, bleeding and infection can occur, which in turn can lead to complications.
This can lead to severe inflammation in the tissue, which sometimes leads to numbness or severe pain. The tumor can also press on nerve and muscle cords and cause a variety of symptoms. In extreme cases, serious circulatory disorders occur in the affected part of the body. Major complications are relatively unlikely when treating a pyogenic granuloma.
However, the surgical procedure carries the risk of bleeding and secondary bleeding. If the tumor is treated with silver nitrate, corresponding side effects (swelling, inflammation, redness, itching) and cosmetic changes can occur. Cryosurgery can lead to wound healing disorders, pus formation and local frostbite.
There is also a risk of permanent tissue disorders. Burns, blisters, and scarring may rarely occur with laser treatment of pyogenic granuloma. The change in chemical tissue structures can lead to long-term problems.
When should you go to the doctor?
Since this disease is a tumor, it should always be treated by a doctor. Treatment by means of self-help cannot be carried out. The earlier the tumor is detected, the higher the probability of a complete cure. A doctor should be consulted if the person concerned discovers an ulcer on his body.
This usually occurs in the neck and head area. During pregnancy, women can develop a tumor in the oral cavity, while men can also develop a tumor on the penis. In most cases, the tumor can be treated and removed relatively well, so that there are no particular complications. The treatment is then carried out by the respective specialist and depends very much on the affected region. The first diagnosis can be made by a general practitioner.
Treatment & Therapy
Treatment of the pyogenic granuloma usually leads to complete healing. In the case of a pregnancy tumor, therapy is not necessary at all because the hemangioma disappears on its own. In most other cases, the tumor can only be removed by surgery. This is done either by cutting out or by laser ablation. The central blood vessel supplying the tumor must be completely removed.
Otherwise, recurrences would form immediately, which would return to the same size a few days after the operation. The surgical procedure can be performed under local anesthesia in adults and general anesthesia in children. Good experiences have also been made with cryosurgery in the past. Another alternative is to apply chemicals such as silver nitrate to the pyogenic granuloma. This can stop bleeding.
Because the cause of pyogenic granuloma is unknown, no general recommendation for its prevention can be made. Only the probability of the pregnancy tumor can be reduced. Since inflammatory processes in the oral cavity during pregnancy promote pyogenic granuloma, intensive oral hygiene can reduce the risk of its outbreak.
After the successful treatment of a pyogenic granuloma, no follow-up treatments are required because the disease does not have any harmful consequences. Since the causes of the development of a pyogenic granuloma have not yet been finally clarified, no follow-up treatments tailored to the cause can be carried out. Certain drugs (antibiotics) are suspected of promoting the development of a pyogenic granuloma. However, this could not be proven in previous studies.
In addition, there is the need to weigh the benefits and risks of using these medications, which means that it is not advisable to do without them altogether. However, there are things that can be done to reduce the likelihood of a pyogenic granuloma coming back. The risk of developing a pyogenic granuloma is generally increased in people who already have one. Intensive skin and body hygiene is recommended to prevent the development of a new pyogenic granuloma.
Because injuries and burns are suspected of promoting pyogenic granuloma formation, they should be avoided. In addition, the scars left after treatment for a pyogenic granuloma can often develop into ugly patches of skin. In order to have a positive influence on the scar development, it is therefore advisable to regularly apply scar gel and/or scar ointment to the scar.