Lobular capillary hemangioma, also known as pyogenic granuloma, is a benign acquired vascular tumor that commonly affects the nail unit. It presents as a rapidly growing vascular nodule that may ulcerate or bleed. When solitary, it is often the result of local trauma such as onychocryptosis, retronychia, or friction from shoes. Self-induced causes include aggressive manicuring, onychotillomania, and onychophagia. It is also associated with peripheral nerve injury including cast immobilization, reflex sympathetic dystrophy, Guillain-Barré syndrome, and hemiplegia.

When lobular capillary hemangiomas involve multiple nails, they may be due to systemic and topical retinoids, antiretrovirals, levothyroxine, anti-epidermal growth factor antibody and epidermal growth factor receptor tyrosine kinase inhibitors, fluoropyrimidine, systemic 5-fluorouracil, taxanes, mitoxantrone, cyclosporine, and anti-CD20 antibody treatment. Systemic disease associations are sarcoidosis, psoriasis, and seronegative spondyloarthritis.

Lobular capillary hemangiomas secondary to drugs are typically localized to the lateral nail fold. If due to ingrown toenails, lobular capillary hemangiomas may be found in the lateral nail fold or nail bed. On the fingers, lobular capillary hemangiomas are most commonly secondary to obvious trauma.