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

See also in: Overview,External and Internal Eye,Hair and Scalp,Oral Mucosal Lesion
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Contributors: Shari Lipner MD, PhD, Belinda Tan MD, PhD, Susan Burgin MD
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Synopsis

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.

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: 10/18/2017
Last Updated: 08/14/2019
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Lobular capillary hemangioma - Nail and Distal Digit
See also in: Overview,External and Internal Eye,Hair and Scalp,Oral Mucosal Lesion
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Lobular capillary hemangioma : Developed acutely , Friable papule, Hemorrhagic skin lesion, Red color
Clinical image of Lobular capillary hemangioma
A close-up of a well-demarcated bleeding papule.
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