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a tumor composed of granulation tissue resulting from injury or inflammation or infection
producing pus

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/03/19 23:03:35」(JST)

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Pyogenic granuloma (also known as a "Eruptive hemangioma", "Granulation tissue-type hemangioma", "Granuloma gravidarum", "Lobular capillary hemangioma", "Pregnancy tumor", and "Tumor of pregnancy"^[1]^[2]) is a vascular lesion that occurs on both mucosa and skin, and appears as an overgrowth of tissue due to irritation, physical trauma or hormonal factors.^[3]^[4] It is often found to involve the gums, the skin and nasal septum, and has also been found far from the head such as in the thigh.^[5]

History and terminology[edit]

Pyogenic granuloma was first described in 1897 by two French surgeons, Poncet and Dor, who named this lesion botryomycosis hominis.^[6]

The name for pyogenic granuloma is misleading because it is not a true granuloma. In actuality, it is a capillary hemangioma of lobular subtype which is the reason they are often quite prone to bleeding.^[4]

It is also not truly pyogenic, ("pus producing") as the cause is traumatic and not infectious.

Signs and symptoms[edit]

Clinical presentation[edit]

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. This is not to say that the pyogenic granuloma can not be bigger but it is more common to see one within these measurements.^{[medical citation needed]} 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. Some cases may also include the granuloma "leaking" an oil like substance causing the surface to be damp. This is especially if the granuloma is located on the scalp.^{[medical citation needed]}

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.^[7] However, this association has been questioned by others.^[8] 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.

Associated conditions[edit]

Due to its overwhelming incidence on the gingiva, the condition is often associated with two other diseases, though not because they occur together. Instead, the three are associated with each other because they appear frequently on gingiva - peripheral giant cell granuloma and peripheral ossifying fibroma. However, detailed analysis can be used to distinguish these conditions.^[9]

The appearance can be very similar to that of a hemangioma but unlike hemangiomas they can appear after birth.

Treatment[edit]

There is usually no treatment if the pyogenic granuloma occurs during pregnancy since the lesion may heal spontaneously. Recurrent bleeding in either the oral or nasal lesions may necessitate excision and cauterization sooner, however. If aesthetics are a concern, then treatment may be pursued as well. Usually, only minor surgery may be needed, along with a dental cleaning for oral lesions to remove any calculus or other source of irritation. For nasal lesions, one should be discouraged from any nose-picking.

Gallery[edit]

References[edit]

^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
^ ^a ^b Jafarzadeh H, Sanatkhani M, Mohtasham N (December 2006). "Oral pyogenic granuloma: a review" (– ^{Scholar search}). J Oral Sci 48 (4): 167–75. doi:10.2334/josnusd.48.167. PMID 17220613. Retrieved 2009-01-04. ^{[dead link]}
^ Nthumba PM (2008). "Giant pyogenic granuloma of the thigh: a case report". J Med Case Reports 2 (1): 95. doi:10.1186/1752-1947-2-95. PMC 2329656. PMID 18377654.
^ Ferry AP, Zimmerman LE. Granuloma pyogenicum of limbus. Arch Ophthalmol 74:229-230, 1965.
^ Lee J, Lynde C (2001). "Pyogenic granuloma: pyogenic again? Association between pyogenic granuloma and Bartonella". J Cutan Med Surg 5 (6): 467–70. doi:10.1007/s10227-001-0022-0. PMID 11907853.
^ Levy I, Rolain JM, Lepidi H, et al. (December 2005). "Is pyogenic granuloma associated with Bartonella infection?". J. Am. Acad. Dermatol. 53 (6): 1065–6. doi:10.1016/j.jaad.2005.08.046. PMID 16310070.
^ Salum FG, Yurgel LS, Cherubini K, De Figueiredo MA, Medeiros IC, Nicola FS (May 2008). "Pyogenic granuloma, peripheral giant cell granuloma and peripheral ossifying fibroma: retrospective analysis of 138 cases". Minerva Stomatol 57 (5): 227–32. PMID 18496485.

UpToDate Contents

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1. 化膿性肉芽腫（小葉状毛細血管腫） pyogenic granuloma lobular capillary hemangioma
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English Journal

[Pyogenic granuloma of the oral mucosa.]

Baratli J1, Hölzle F, Megahed M.Author information 1Klinik für Dermatologie und Allergologie, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland, jbaratli@ukaachen.de.AbstractPyogenic granuloma is regarded as a vascular proliferation that may result from trauma or local irritation. The most common intraoral site is the gingiva, affected in 75 % of cases. Therapy of pyogenic granuloma consists of surgical excision. Recurrence after excision may occur. In our patient, there were no post-operative complications.
Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete.Hautarzt.2014 Apr 12. [Epub ahead of print]
Pyogenic granuloma is regarded as a vascular proliferation that may result from trauma or local irritation. The most common intraoral site is the gingiva, affected in 75 % of cases. Therapy of pyogenic granuloma consists of surgical excision. Recurrence after excision may occur. In our patient, th
PMID 24722911

Cutaneous horn arising from an area of discoid lupus erythematosus on the scalp.

Fatani MI1, Hussain WM, Baltow B, Alsharif S.Author information 1Department of Medicine, Hera General Hospital, Makkah, Saudi Arabia.AbstractA cutaneous horn is a rare clinical condition characterised by a conical projection of hyperkeratotic epidermis. Cutaneous horns most commonly arise from sun-exposed skin in elderly men, but may arise from any part of the body at any age in men and women. When a cutaneous horn forms, it is important to determine the underlying cause. Various skin diseases may present with cutaneous horns including viral warts, actinic keratosis, keratoacanthoma, seborrhoeic keratosis, pyogenic granuloma, discoid lupus erythematosus, verruca vulgaris, Bowen's disease, basal cell carcinoma and squamous cell carcinoma. The underlying pathology is benign in 61.1% of cases, premalignant in 23.2% of cases and malignant in 15.7% of cases. We report a patient with a cutaneous horn arising from an area of discoid lupus erythematosus on the scalp.
BMJ case reports.BMJ Case Rep.2014 Apr 3;2014. pii: bcr2013202322. doi: 10.1136/bcr-2013-202322.
A cutaneous horn is a rare clinical condition characterised by a conical projection of hyperkeratotic epidermis. Cutaneous horns most commonly arise from sun-exposed skin in elderly men, but may arise from any part of the body at any age in men and women. When a cutaneous horn forms, it is important
PMID 24700037

A rare cause of haematochezia: pyogenic granuloma in colon.

Lui KL1, Ng KS2, Li MK1.
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine.Hong Kong Med J.2014 Apr;20(2):168.e1-e2. doi: 10.12809/hkmj133844.
PMID 24714175

Japanese Journal

爪甲下に生じたエクリン汗孔腫の1例

吉岡希,椋棒圭子,磯貝理恵子,山田秀和
皮膚の科学 12(1), 35-38, 2013
61歳，女性。平成19年頃より右母趾爪甲下に腫瘤が出現し，近医にて血管拡張性肉芽腫の診断のもとに液体窒素で冷凍治療を施されたが症状は変わらず，その後放置していた。平成22年秋頃より外傷をきっかけとして滲出液を認めるようになったため，平成23年2月に当院を受診した。初診時，爪甲下に淡紅色の腫瘤を認めたが爪甲は破壊されていなかった。生検の結果，エクリン汗孔腫と診断し，腫瘤を切除し植皮術を行った。爪甲下 …
NAID 130004546929

Crohn病に合併したSweet病の経過中に多発性骨髄腫と壊疸性膿皮症を発症した1例

國行秀一,吉田有紀,山中一星 [他]
日本皮膚科学会雑誌 122(1), 31-37, 2012-01
NAID 40019180309

Ｄｅｓｍｏｐｌａｓｔｉｃ　Ｍａｌｉｇｎａｎｔ　Ｍｅｌａｎｏｍａの１例

國行秀一,前川直輝,吉田有紀,山中一星
西日本皮膚科 70(2), 153-158, 2008
71歳，男性。初診の3年前ごろより，右手掌に黒褐色胼胝様皮疹が出現し，その後徐々に表面びらん状となり，さらに隆起性赤色腫瘤状になった。臨床的に血管拡張性肉芽腫が疑われた。病理組織検査では真皮内に紡錘形細胞が充満しており,一部の細胞内にメラニン沈着を認めた。また免疫組織学的検索でS-100(+)，HMB-45(-)，Vimentin(+)，Cytokeratin(-)，<I>α</ …
NAID 130004475227

「毛細血管拡張性肉芽腫」

Pyogenic granuloma
	Classification and external resources
ICD-10	L98.0
ICD-9	686.1
DiseasesDB	29385
MedlinePlus	001464
eMedicine	ped/1244
MeSH	D017789

　　[★]

英: teleangiectatic granuloma (NDE)
ラ: granuloma teleangiectaticum
同: 血管拡張性肉芽腫、化膿性肉芽腫, granuloma pyogenicum, pyogenic granuloma、ボトリオミコーゼ, botryomycosis
関: 血管腫、脈管系腫瘍

[show details]

毛細血管拡張性肉芽腫 : 約 4,370 件
血管拡張性肉芽腫 : 約 13,400 件
teleangiectatic granuloma 毛細血管拡張性肉芽腫 : 3 件
teleangiectatic granuloma 血管拡張性肉芽腫 : 約 6 件

外傷がきっかけとなって発生する毛細血管とその内腔の増殖による血管腫の一種。
数週間の経過で増大し続ける。無色素性黒色腫との鑑別が必要である。(参考1)
良性の病変である。
治療は外科的切除、凍結療法、レーザー切除。

参考

1. [charged] Overview of benign lesions of the skin - uptodate [1]

「pyogenic」

　　[★]

adj.

化膿性の

関: purulent、pyogenes、suppurative

[Andrews-1] James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.

[Bolognia-2] Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.

[Fitz2-3] Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.

[joralsci-4] Jafarzadeh H, Sanatkhani M, Mohtasham N (December 2006). "Oral pyogenic granuloma: a review" (– ^{Scholar search}). J Oral Sci 48 (4): 167–75. doi:10.2334/josnusd.48.167. PMID 17220613. Retrieved 2009-01-04. ^{[dead link]}

[Nthumba-5] Nthumba PM (2008). "Giant pyogenic granuloma of the thigh: a case report". J Med Case Reports 2 (1): 95. doi:10.1186/1752-1947-2-95. PMC 2329656. PMID 18377654.

[6] Ferry AP, Zimmerman LE. Granuloma pyogenicum of limbus. Arch Ophthalmol 74:229-230, 1965.

[pmid11907853-7] Lee J, Lynde C (2001). "Pyogenic granuloma: pyogenic again? Association between pyogenic granuloma and Bartonella". J Cutan Med Surg 5 (6): 467–70. doi:10.1007/s10227-001-0022-0. PMID 11907853.

[pmid16310070-8] Levy I, Rolain JM, Lepidi H, et al. (December 2005). "Is pyogenic granuloma associated with Bartonella infection?". J. Am. Acad. Dermatol. 53 (6): 1065–6. doi:10.1016/j.jaad.2005.08.046. PMID 16310070.

[pmid18496485-9] Salum FG, Yurgel LS, Cherubini K, De Figueiredo MA, Medeiros IC, Nicola FS (May 2008). "Pyogenic granuloma, peripheral giant cell granuloma and peripheral ossifying fibroma: retrospective analysis of 138 cases". Minerva Stomatol 57 (5): 227–32. PMID 18496485.

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案内

granuloma pyogenicum