Pyogenic Granuloma Arising as a Complication of 595 nm Tunable Pulsed Dye Laser Treatment of Port-Wine Stains: Report of Four Cases

Liu, Shengxiu; Yang, Chonglin; Xu, Shengxin; Yuan, Changzheng; Yang, Sen; Zhang, Xuejun

doi:10.1111/j.1524-4725.2010.01636.x

Cited by 9 publications

(9 citation statements)

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“…It is also known that pyogenic granulomas are a complication of certain vascular malformations, mainly capillary 14 and arteriovenous ones, 8,9 where they can develop spontaneously, during pregnancy, 14,15 or after a local injury including treatment with pulsed dye laser. 16 To our knowledge, pyogenic granulomas emerging over venous malformations has not been previously described. In conclusion, a 52-year-old male developed pyogenic granulomas over the venous component of a mixed capillary-venous malformation without apparent relationship to local injury.…”

Section: Discussionmentioning

confidence: 87%

“…In a similar way, after trauma, different angiogenic factors could stimulate endothelial proliferation leading to the development of a pyogenic granuloma. It is also known that pyogenic granulomas are a complication of certain vascular malformations, mainly capillary and arteriovenous ones, where they can develop spontaneously, during pregnancy, or after a local injury including treatment with pulsed dye laser . To our knowledge, pyogenic granulomas emerging over venous malformations has not been previously described.…”

Section: Discussionmentioning

confidence: 99%

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Pyogenic granuloma over the venous component of a mixed vascular malformation

2019

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A 52‐year‐old man presented with a rapidly growing red tumor on the central neckline. It had appeared over a congenital flat and pinkish vascular lesion that involved the shoulder and the upper anterior area of his chest. Intermingled with the pinkish stain, there were also some blue nodules several millimeters in diameter. Histopathologic examination revealed that the full lesion was a mixed venous‐capillary malformation. The red tumor was excised and diagnosed as a pyogenic granuloma developing over the venous component of the vascular malformation. To our knowledge, a pyogenic granuloma growing over a venous malformation has not been previously described.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Pyogenic granuloma over the venous component of a mixed vascular malformation

2019

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“…Reports of multiple PGs overlying an AV or capillary malformation are rare (4,12–15). Some cases of multiple PGs arising in the setting of vascular malformations may have resulted from cutaneous injury due to therapy (e.g., pulsed dye laser treatment or cryotherapy) (16–22) or developed during pregnancy, a known predisposing factor for PG (10). Most of these published cases developed in older children and adults as small and scattered lesions rather than forming a coalescing plaque as in the cases reported herein.…”

Section: Discussionmentioning

confidence: 99%

Agminated, Eruptive Pyogenic Granuloma‐Like Lesions Developing over Congenital Vascular Stains

Baselga

Wassef

López

et al. 2011

Pediatric Dermatology

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“…Etiology of the lesions is unknown, but predisposing factors that have been reported include pregnancy, trauma, and vascular malformations such as port wine stains (before, during, or after therapy) 2 . Pyogenic granulomata have been cited in several case reports as a potential complication of the treatment of these malformations with laser therapy, including the 595‐nm PDL 3 . Differential diagnosis includes amelanotic melanoma and, in immunocompromised patients, Kaposi's sarcoma or bacillary angiomatosis.…”

Section: Discussionmentioning

confidence: 99%

“…2 Pyogenic granulomata have been cited in several case reports as a potential complication of the treatment of these malformations with laser therapy, including the 595-nm PDL. 3 Differential diagnosis includes amelanotic melanoma and, in immunocompromised patients, Kaposi's sarcoma or bacillary angiomatosis. Other lesions that may mimic pyogenic granulomata include warts, hemangiomas, glomus tumors, and irritated melanocytic nevi.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Multiple Periungual Pyogenic Granulomata from Pincer Nails with Pulsed Dye Laser

Miller

Levitt

2011

Dermatologic Surgery

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The authors have indicated no significant interest with commercial supporters.M ultiple periungual pyogenic granulomata are an uncommon phenomenon. We present a case of a 16-year-old boy with multiple pyogenic granulomata of the nail folds caused by pincer nails. These lesions were successfully treated with two sessions of pulsed dye laser (PDL; 595 nm, 7-mm spot size, 8 J/cm 2 , 0.45-ms pulse width) with a 1-week interval after failure of surgical excision, and their recurrence has been prevented with appropriate home nail care. Along with this interesting case, a brief review of the reported causes of multiple periungual pyogenic granulomata and the treatment of pyogenic granulomata with PDL will be discussed. CaseA 16-year-old boy presented to clinic with a 6-month history of a friable papule on the lateral periungual region of the left third finger. He was first seen at an outside clinic where the lesion was thought to be an abscess and treated with incision and drainage. He had also been treated with amoxicillin/clavulanic acid, ciprofloxacin, and topical mupirocin. The lesion did not heal, remaining painful, friable, and occasionally purulent. He underwent a biopsy, which was consistent with pyogenic granuloma, followed by surgical resection, with subsequent complete recurrence.On examination at our clinic, pincer nails were noted, as well as an eroded, crusted papule of the lateral nail fold of the left third finger (Figure 1). The patient was started on imiquimod 5% cream once daily. After 3 weeks of treatment, his finger appeared more edematous and erythematous, and he had begun to develop a similar lesion on the fourth finger, which he was also treating with imiquimod. At that time, because of concern for superinfection, imiquimod was discontinued, and the patient was started on a 7-day course of levofloxacin along with topical econazole and triple antibiotic ointment. Fungal and bacterial cultures were negative. Another biopsy was performed showing vascular proliferation with a dense lymphoid infiltrate. At this time, we debrided the serosanguineous crust from the lesions, along with the offending portion of the nail plates (Figure 2), and treated the lesions with pulsed dye laser (PDL; 595 nm, 7-mm spot size, 8 J/cm 2 , 0.45-ms pulse width) in two sessions 1 week apart. These aggressive laser settings were chosen to maximize the therapeutic response by delivering the greatest amount of energy in the least amount of time. Prior experience in treating these lesions with longer pulse widths, specifically, had not proven to be successful. Pulses were stacked two to three times, with purpura being the point at which a therapeutically meaningful dose of energy was thought to be delivered ( Figure 3A). The patient was then counseled to cut his nails straight across and allow them to grow out slightly and he was shown how to tape the nail fold back to alleviate pressure. He was also

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Pyogenic Granuloma Arising as a Complication of 595 nm Tunable Pulsed Dye Laser Treatment of Port-Wine Stains: Report of Four Cases

Abstract: The authors have indicated no significant interest with commercial supporters.

Cited by 9 publications

References 5 publications

Pyogenic granuloma over the venous component of a mixed vascular malformation

Pyogenic granuloma over the venous component of a mixed vascular malformation

Agminated, Eruptive Pyogenic Granuloma‐Like Lesions Developing over Congenital Vascular Stains

Treatment of Multiple Periungual Pyogenic Granulomata from Pincer Nails with Pulsed Dye Laser

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