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 individuals 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).