Pyogenic Granuloma - Signs and Symptoms - Clinical Presentation

Clinical Presentation

The appearance of pyogenic granuloma is usually a color ranging from red/pink to purple, and can be smooth or lobulated. Younger lesions are more likely to be red because of the high number of blood vessels. Older lesions begin to change into a pink color. Size ranges from a few millimeters to centimeters. It can be painful, especially if located in an area of the body where it is constantly disturbed. Pyogenic granulomas can grow rapidly and will often bleed profusely with little or no trauma.

It is most likely to occur in children and younger adults, and there is a definite gender difference with more females affected than men. In pregnant women, it is most likely to occur in the first trimester with an increasing incidence up until the seventh month and is often seen on the anterior nasal septum as a source of frequent nose bleeds. Pyogenic granulomas appear on the gingiva in 75% of cases, more often in the maxillary than mandibular jaw. Anterior areas are more often affected than posterior areas. It can also be found on the lips, tongue, and inner cheek. Poor oral hygiene or trauma are usually precipitating factors.

One study has suggested a correlation between pyogenic granuloma and Bartonella seropositivity. However, this association has been questioned by others. The appearance of a pyogenic granulomas microscopically has a highly vascular granulation tissue. Inflammation is present. The lesion may have a fibrous character if it is older, and the surface may have ulcerations. Pyogenic granuloma rarely occurs in the conjunctiva, cornea or connective tissue of the eye following minor local trauma. Grossly these mass lesions resemble those occurring at more common sites. The relationship of this lesion to the lobular capillary hemangioma of skin and oropharyngeal mucosa commonly referred to as pyogenic granuloma is uncertain.