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What Causes Granuloma Pyogenicum?

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Posted on Thu, 4 Sep 2014
Question: On the fourth of July, I noticed my back was bleeding. It bled A LOT...through my shirt and sweater, but there was only a tiny tiny marking on my back when I saw where the blood was coming from. A few days later, it developed into a flesh colored bump and continued to bleed all the time. It has since been five weeks, and the area looks like a blood blister and has grown tremendously. It started as a dot you could hardly see and now is about the size of a small grape. It bleeds all of the time and is shaped like a dome. I googled what this could be, and I am a little nervous this is nodular melanoma. I have a doctors appointment Friday at a surgical derm but I wanted to have a doctors advice sooner. This is location on my upper back near the center. Again, in about 5 weeks, it has significantly grown. IT ranges from brownish/black, to a raw looking red based on if it bleeds. It bleeds every time i shower and also through my clothes and all over my sheets when I wake up each morning. When I say bleeding, it really bleeds. Once it even squirted blood onto my boyfriend when he was trying to put pressure to get it stop. It bleeds through three band aids at least once a day. In the last week, the lesion has doubled in size and continues to grow. I will include pictures of the lesion, as well as progression pictures each week.
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Answered by Dr. Sanjay Kumar Kanodia (1 hour later)
Brief Answer:
Pyogenic granuloma: completely benign condition.

Detailed Answer:
Hello young fellow,

Welcome and thanks for posting your query to the forum.

I can understand your concern for the possibility of melanoma after the growth and increase in size with bleeding.

I have gone through the complete query and all your pictures and with best of my knowledge I reassure you that the area do not appear as cancerous or precancerous and therefore has no relation to any type of melanoma.

So young lady you must be wondering what the exact entity do you have!!!

Your condition is known as "granuloma pyogenicum" or Pyogenic granuloma. It is totally benign condition and is not related to moles. It is formed due to over proliferation of blood vessels. This can be due to friction or trauma or due to hormonal factors.

I correlate it with your hormonal tablet- XXXXXXX I quite often see your kind of condition in young females taking hormonal pills and developing these kind of lesions.

The typical feature of this condition is that it bleeds even on trivial touch.

You can see in the picture that the initial lesion is red and not pigmented later getting enlarged and then bleeding profusely- which is the typical manifestation of Pyogenic granuloma.

You can go on net and see the pictures for ready reference.

For the treatment part - it can be excised very easily and never cause any future issues as is completely benign condition.

If at all if I had kept a second possibility then would like to keep a possibility of - infected mole where due to mild to moderate infection there can be later appearance of bleeding lesion.

But overall in my experience I would keep Pyogenic granuloma as best of my diagnosis. So rest assured for any serious possibility.


Let me guide certain points not in favor of Nodular melanoma:

Nodular melanoma develops on normal skin rather than on pre-existing mole or an any other lesion. These are most commonly seen in the fifth or sixth decade (not in young females of your age) and occurs more frequently in males than in females.

These are basically quite deep and therefore dark in color rather than red bleeding lesions.

Bleeding too occur very late and not just in 4-5 weeks. So all of these points are in disfavor of Nodular melanoma in your case.

So do not think of anything serious about it. Looking to your lesions it shows quite normal kind of Pyogenic granuloma.


Just relax and do not worry.

I hope these informations will relax you. I will be glad to answer any further queries.

My all best wishes for your healthy life.

With regards,

Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sanjay Kumar Kanodia

Dermatologist

Practicing since :2002

Answered : 4165 Questions

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What Causes Granuloma Pyogenicum?

Brief Answer: Pyogenic granuloma: completely benign condition. Detailed Answer: Hello young fellow, Welcome and thanks for posting your query to the forum. I can understand your concern for the possibility of melanoma after the growth and increase in size with bleeding. I have gone through the complete query and all your pictures and with best of my knowledge I reassure you that the area do not appear as cancerous or precancerous and therefore has no relation to any type of melanoma. So young lady you must be wondering what the exact entity do you have!!! Your condition is known as "granuloma pyogenicum" or Pyogenic granuloma. It is totally benign condition and is not related to moles. It is formed due to over proliferation of blood vessels. This can be due to friction or trauma or due to hormonal factors. I correlate it with your hormonal tablet- XXXXXXX I quite often see your kind of condition in young females taking hormonal pills and developing these kind of lesions. The typical feature of this condition is that it bleeds even on trivial touch. You can see in the picture that the initial lesion is red and not pigmented later getting enlarged and then bleeding profusely- which is the typical manifestation of Pyogenic granuloma. You can go on net and see the pictures for ready reference. For the treatment part - it can be excised very easily and never cause any future issues as is completely benign condition. If at all if I had kept a second possibility then would like to keep a possibility of - infected mole where due to mild to moderate infection there can be later appearance of bleeding lesion. But overall in my experience I would keep Pyogenic granuloma as best of my diagnosis. So rest assured for any serious possibility. Let me guide certain points not in favor of Nodular melanoma: Nodular melanoma develops on normal skin rather than on pre-existing mole or an any other lesion. These are most commonly seen in the fifth or sixth decade (not in young females of your age) and occurs more frequently in males than in females. These are basically quite deep and therefore dark in color rather than red bleeding lesions. Bleeding too occur very late and not just in 4-5 weeks. So all of these points are in disfavor of Nodular melanoma in your case. So do not think of anything serious about it. Looking to your lesions it shows quite normal kind of Pyogenic granuloma. Just relax and do not worry. I hope these informations will relax you. I will be glad to answer any further queries. My all best wishes for your healthy life. With regards, Dr Sanjay Kumar Kanodia MD- Dermatology & Sexually transmitted diseases