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Pathology

1. Pyogenic granuloma: rapidly growing capillary haemangioma which usually measures less than 1cm in diameter
2. It is neither pyogenic nor a granuloma

Approach

• Examine as for any lump

1. Inspect
   • Bright red or blood encrusted hemispherical nodule
   • May be sessile or pedunculated
   • May be associated with serous or purulent discharge
   • Can be skin coloured if longstanding (due to epithelialisation)
2. Palpate
   • Soft/fleshy in consistency
   • Slightly compressible (due to vascular origin)
   • May bleed easily (palpate only if asked to)

Completion

1. Ask about previous injury to the area
   • Link with trauma
2. How long the lump took to appear (rapid growth in afew days)
3. How the lump affects the patient's life

Treatment

1. Non-surgical
   • Regression is uncommon except in those arising from pregnancy
2. Surgical
   • Best treated surgically
   • Curettage with diathermy of the base
   • Complete excision biopsy (if recurrent, consider malignancy - amelanotic melanoma)