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Lobular capillary hemangioma in Adult
See also in: External and Internal Eye,Hair and Scalp,Nail and Distal Digit,Oral Mucosal Lesion
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Lobular capillary hemangioma in Adult

See also in: External and Internal Eye,Hair and Scalp,Nail and Distal Digit,Oral Mucosal Lesion
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Contributors: Jeffrey M. Cohen MD, Belinda Tan MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Lobular capillary hemangiomas, also known as pyogenic granulomas, are rapidly growing, benign vascular proliferations of the skin and mucous membranes. While the etiology remains incompletely understood, multiple precipitants including infectious organisms, eczematous dermatitis, penetrating or chronic injury, hormonal fluctuations, and retinoid therapy have been reported.

The majority of patients appear to have no predisposing factors to the development of lobular capillary hemangiomas, which may be cutaneous, mucosal, subcutaneous, or intravascular, the latter two of which have been rarely reported.

Common cutaneous sites are the trunk, head and neck, and extremities, particularly the hands and fingers. Common mucosal sites are gingiva, cheeks, and lips. Since lobular capillary hemangiomas can present in areas of active inflammation or injury, gingivitis and periodontitis are considered risk factors. Lobular capillary hemangiomas are generally painless but ulcerate and bleed easily after minor trauma.

Reports suggest that the lesion is most common in children and young adults, although lobular capillary hemangiomas have been cited in nearly every age group. Mean age of presentation is the second and third decades of life. Cutaneous lobular capillary hemangiomas appear to have a slight predilection for males, whereas mucosal lobular capillary hemangiomas are nearly two times more common in females than in males. Some studies suggest that a hormonal influence on mucosal tissue may account for this difference. Nearly 5% of pregnant women develop the lesion on the oral mucosa (granuloma gravidarum) in the second or third trimester. Vulvar lobular capillary hemangiomas have also been reported.

Drugs associated with periungual lobular capillary hemangiomas include isotretinoin, topical retinoids, indinavir, 5-fluorouracil, capecitabine, mitoxantrone, and epidermal growth factor inhibitors (EGFR inhibitors).

Codes

ICD10CM:
L98.0 – Pyogenic granuloma

SNOMEDCT:
200722003 – Pyogenic granuloma

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 11/15/2017
Last Updated: 12/04/2017
Copyright © 2018 VisualDx®. All rights reserved.
Lobular capillary hemangioma in Adult
See also in: External and Internal Eye,Hair and Scalp,Nail and Distal Digit,Oral Mucosal Lesion
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Lobular capillary hemangioma : Developed acutely over days to weeks, Friable papule, Hemorrhagic skin lesion, Red color
Clinical image of Lobular capillary hemangioma
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