Localized vs Generalized Pyogenic Granuloma

Abstract

We herein report the unusual case of a previously healthy young man who had spontaneous development of multiple lobular capillary hemangiomata disseminated over the integument. Based on the observation that the single lesions exhibited (immuno)pathologic and ultrastructural features similar, if not identical, to those of late-stage pyogenic granulomas, we propose to nosologically include our patient's eruption within the disease spectrum of pyogenic granuloma. As opposed to the occurrence of localized forms of pyogenic granuloma, the disseminated eruption seen in our patient and in other patients whose cases are reported in the literature cannot be ascribed to physical trauma. As some of these latter patients suffered from an underlying malignant neoplasm, it is tempting to speculate that both exogenous (eg, trauma) and endogenous (eg, tumor cells) factors can lead to the release of mediators promoting the development of these vascular neoplasms.

Recurrent intraoral pyogenic granuloma with satellitosis treated with corticosteroids

“…The pathogenesis of this phenomenon is unclear. One author suggested that exogenous factors such as trauma and endogenous substances released from tumor cells may promote the development of these granulomas (Strohal et al , 1991). We describe a case of a intra‐oral pyogenic granuloma with recurrent nodules in the site of previously treated healing wound and adjacent gingival tissue resembling satellitosis on the skin.…”

Disseminated lobular capillary haemangioma

“…On review of the literature, only nine cases 10–17 of disseminated lobular capillary haemangioma have been reported (Table 2). These cases were characterized by the sudden development of numerous widespread lobular capillary haemangiomas ranging in size from 1 to 10 mm.…”

Agminated lobular capillary hemangiomas presumably associated with an acquired arteriovenous malformation

“…In addition to microscopic arteriovenous anastomoses, Strohal et al. 9 have suggested that an underlying inflammatory or neoplastic disease could trigger the development of multiple LCH's with release of angiogenic factors. Shimizu et al.…”