A 23-year-old woman who is 10 weeks pregnant presents with a rapidly growing lesion on her finger. This has grown from the size of a ‘pin-prick’ when it first appeared 4 weeks ago.
What is the most likely diagnosis?
Viral wart
Orf
Pyogenic granuloma
Capillary haemangioma
Squamous cell carcinoma
Pyogenic granuloma
Pyogenic granuloma is a relatively common benign skin lesion. The name is confusing as they are neither true granulomas nor pyogenic in nature. There are multiple alternative names but perhaps ‘eruptive haemangioma’ is the most useful.
The cause of pyogenic granuloma is not known but a number of factors are linked:
trauma
pregnancy
more common in women and young adults
Features
most common sites are head/neck, upper trunk and hands. Lesions in the oral mucosa are common in pregnancy
initially small red/brown spot
rapidly progress within days to weeks forming raised, red/brown lesions which are often spherical in shape
the lesions may bleed profusely or ulcerate
Management
lesions associated with pregnancy often resolve spontaneously post-partum
other lesions usually persist. Removal methods include curettage and cauterisation, cryotherapy, excision
