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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）』「2014/07/26 15:09:36」(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

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

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. 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

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

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

References

^ 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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4. 皮膚の良性病変の概要 overview of benign lesions of the skin
5. スピッツ母斑様色素細胞性腫瘍：スピッツ母斑および異型スピッツ腫瘍：臨床的特徴、
診断および管理 spitzoid melanocytic neoplasms spitz nevus and atypical spitz tumors

English Journal

Treatment of giant pyogenic granuloma with the Nd/YAG holmium laser: a case report.

Yang C, Liu S.SourceInstitute of Dermatology & Department of Dermatology at No.1 Hospital, Anhui Medical University , Hefei, Anhui 230022 , P. R. China.
Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology.J Cosmet Laser Ther.2013 Mar 6. [Epub ahead of print]
Pyogenic granuloma (PG) is a common vascular tumor that can be treated using various means. However, some large lesions and those located on some difficult-to-treat body sites may represent a formidable selection to the clinician because of the residual pain after treatment, difficulties in surgical
PMID 23464531

Obliterative lower airway lesions in childhood: Bronchoscopic diagnosis and clinical spectrum.

Quizon A, Minic P, Pohunek P, Tal A, Colin AA.SourceDivision of Pediatric Pulmonology, University of Miami-Miller School of Medicine, Miami, Florida. aquizon@med.miami.edu.
Pediatric pulmonology.Pediatr Pulmonol.2013 Mar 4. doi: 10.1002/ppul.22775. [Epub ahead of print]
Previous reports have described structural airway abnormalities in children with non-cystic fibrosis chronic suppurative lung disease as well as obliterative membranes in the major bronchi of cystic fibrosis patients. The putative paradigm proposed in the evolution of these membranes invokes intense
PMID 23460476

Japanese Journal

症例手掌に発生した化膿性肉芽腫の1例 (特集骨軟部・頭頸部最新情報2012)

原口貴史,野崎太希,松迫正樹 [他]
臨床放射線 57(13), 1863-1866, 2012-12
NAID 40019528147

非異物性化膿性肉芽腫の犬の1例

中田美央,秋吉秀保,湯川尚一郎,針間矢保治,桑村充,山手丈至,清水純一郎,大橋文人
日本獣医師会雑誌 = Journal of the Japan Veterinary Medical Association 65(5), 370-373, 2012-05-20
NAID 10030648310

Related Pictures

★リンクテーブル★

リンク元	「毛細血管拡張性肉芽腫」
関連記事	「pyogenic」

「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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pyogenic granuloma