Pyogenic Granuloma ICD-10: L98.0

Benign vascular skin lesion

Often searched as: red bump that bleeds easily, bright red growth on skin, bleeds when touched skin bump, red lump that appeared quickly, bleeding spot on skin, gum bump that bleeds, vascular skin bump, red pimple that bleeds a lot…

Clinical urgency level

lowmediumhigh

Systems Affected

skinmucous membranes (gums, oral cavity)

Severity Levels

mild

Small (< 5mm), stable pyogenic granuloma with minor bleeding only when bumped — may be observed or treated electively.

moderate

Larger lesion (5–10mm), frequent spontaneous bleeding, cosmetically bothersome, or in a functionally sensitive area — treatment recommended (shave excision, laser, cryotherapy).

severe

Large or recurrent pyogenic granuloma, involvement of the oral mucosa causing eating difficulty, or multiple satellite lesions after prior treatment — requires surgical excision and histological confirmation.

Red Flags

Profuse or difficult-to-stop bleeding from the lesion
Rapid growth beyond 1cm within weeks
Lesion not responding to initial treatment and continuing to grow
Multiple new satellite lesions appearing around a treated site (recurrent PG)
Pyogenic granuloma during pregnancy that is rapidly enlarging on the gums (granuloma gravidarum)
Any vascular lesion on the face that is growing fast — must rule out amelanotic melanoma

Clinical Presentation

Pyogenic granuloma — bright red pedunculated bleeding nodule on the finger

Source: Wikimedia Commons (CC BY-SA 3.0 )

Pyogenic granuloma image gallery — DermNet NZ

View gallery on DermNet NZ (image gallery reference)

When to See a Doctor

See a dermatologist for any rapidly growing bright red skin bump that bleeds easily — even with minor contact. Pyogenic granulomas do not resolve on their own and require treatment. Because they can occasionally mimic amelanotic melanoma or other serious vascular tumors, a professional evaluation is important, especially for lesions on the face or that are growing quickly.

Differential Diagnosis

Amelanotic melanoma (critical — fast-growing red nodule, can look identical)
Kaposi sarcoma (in HIV — violaceous nodules)
Bacillary angiomatosis (in immunocompromised — bacterial, similar appearance)
Hemangioma (usually present from infancy)
Spitz nevus / spitzoid melanoma
Glomus tumor (usually under fingernail — very painful)
Cherry angioma (small, stable — not rapidly growing)

Comorbidities

Pregnancy (granuloma gravidarum — gingival lesions during pregnancy)
Oral trauma or gingivitis
Medications: retinoids, antiretrovirals, EGFR inhibitors (can trigger PG as side effect)
Minor skin trauma or foreign body

Prognosis

Pyogenic granuloma does not resolve spontaneously and requires treatment. Shave excision followed by curettage and electrodesiccation of the base is the most common approach, with recurrence rates of 5–15%. Laser treatment and cryotherapy are alternatives. Recurrence is the main challenge — satellite lesions can appear around the original site after treatment. Histological confirmation is important to rule out malignant mimickers. Granuloma gravidarum (pregnancy-associated) may regress after delivery but often requires treatment during pregnancy if bleeding is significant.

Detailed Overview

Causes, Symptoms, and When to Take Action Pyogenic granuloma — also known as lobular capillary hemangioma — is a benign vascular lesion that commonly arises on the skin or mucous membranes. Despite its name, it is neither pyogenic nor a true granuloma. How It Looks Texture: A glistening red papule or nodule that often bleeds easily and may ulcerate Color: Bright red to reddish-purple Shape: Rapidly growing, usually solitary, and often attached by a stalk (pedunculated); occasionally sessile or plaque-like Location: Frequently appears on the skin of children and young adults, commonly involving the head, neck, extremities, and oral mucosa; during pregnancy, gingival lesions (granuloma gravidarum) may arise Why Does It Appear? The exact cause remains unclear. Proposed contributing factors include: Local tissue injury or minor trauma Hormonal influences (e.g., during pregnancy) Medications or infections in rare cases These factors may disrupt the balance of angiogenic signals, leading to rapid capillary growth. Should You Be Concerned? Although benign, pyogenic granulomas may cause bleeding, discomfort, or cosmetic concerns. Any of the following signs warrant evaluation: Rapid growth or frequent bleeding Persistent lesions or atypical appearance Localization in sensitive or functionally critical areas Can You Prevent It? Specific prevention methods are not established. However: Avoiding unnecessary trauma to skin and mucosa Monitoring hormonal changes (e.g., during pregnancy) Securing prompt evaluation of new or evolving lesions can help manage potential risk. 👉 How Piel AI Can Help Piel AI allows you to monitor lesion changes through regular imaging. While not diagnostic, it can help track stability or progression and facilitate discussions with healthcare providers. Summary Pyogenic granuloma is a benign vascular lesion with rapid growth and frequent bleeding. It appears as a bright red, often pedunculated papule or nodule. Triggers may include trauma, hormones, or medications. Early evaluation is advised if the lesion bleeds, grows, or changes.

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