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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
Contributors: Jeffrey M. Cohen MD, Belinda Tan MD, PhD, Susan Burgin MD
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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).


L98.0 – Pyogenic granuloma

200722003 – Pyogenic granuloma

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Last Reviewed:11/14/2017
Last Updated:08/12/2021
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Patient Information for Lobular capillary hemangioma in Adult
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Contributors: Medical staff writer


Lobular capillary hemangioma, also known as pyogenic granuloma, is a common, benign growth that often appears as a rapidly growing, bleeding bump on the skin or inside the mouth. It is composed of blood vessels and may occur at the site of minor injury.

When a lobular capillary hemangioma occurs in a pregnant woman, it is sometimes called a "pregnancy tumor" (granuloma gravidarum). Lobular capillary hemangiomas develop in up to 5% of pregnant women.

Who’s At Risk

Lobular capillary hemangiomas occur in people of all races. Women are more frequently affected by lobular capillary hemangiomas than men, although male and female children are equally affected.

Lobular capillary hemangiomas are most often seen in:
  • Children and young adults
  • Pregnant women
  • Women taking oral contraceptives
  • People taking certain oral retinoid medications, including isotretinoin or acitretin (Soriatane)
  • People taking protease inhibitors such as indinavir (Crixivan)
  • People on chemotherapy

Signs & Symptoms

The most common locations for lobular capillary hemangiomas include:
  • Lips, gums, and inner mouth (particularly in pregnant women)
  • Hands and fingers
  • Head and neck
  • Feet and toes
  • Upper trunk
Typically, lobular capillary hemangiomas appear as a beefy, red bump that enlarges rapidly over a few weeks. On average, lobular capillary hemangiomas are about 5-10 mm in diameter. They may bleed easily and, in some cases, can be tender. Very rarely, more than one lesion of lobular capillary hemangiomas may develop at the same time at the same site.

Self-Care Guidelines

See your doctor if you notice any rapidly enlarging skin growth in order to establish a correct diagnosis. Because it is prone to easy bleeding, a lobular capillary hemangioma lesion should be covered with a bandage until you see your doctor.

When to Seek Medical Care

Make an appointment with a dermatologist or another physician if any rapidly enlarging or bleeding growth develops on your skin or in the areas lining your nose or mouth (mucous membranes).


If the diagnosis of lobular capillary hemangioma is suspected, your doctor will probably want to perform a skin biopsy. The procedure involves:
  1. Numbing the skin with an injectable anesthetic.
  2. Sampling a small piece of skin by using a flexible razor blade, a scalpel, or a tiny cookie cutter (called a "punch biopsy"). If a punch biopsy is taken, a stitch (suture) or two may be placed and will need to be removed 6-14 days later.
  3. Having the skin sample examined under the microscope by a specially trained physician (dermatopathologist).
Lobular capillary hemangiomas that develop in pregnant women often resolve after delivery. Similarly, lobular capillary hemangiomas associated with medications usually improve when the medicine is discontinued or the dosage is lowered. Depending on the size of the lobular capillary hemangioma and its location and symptoms, the doctor may decide that no treatment is necessary for pregnant women or for people who can safely stop or lower the dose of the medication that caused the lesion.

Although lobular capillary hemangioma is a benign condition, it is frequently removed due to its tendency to bleed, its tenderness, and its distressing appearance. However, untreated lobular capillary hemangiomas may go away on their own.

In obvious cases of lobular capillary hemangioma, your physician may choose to treat it immediately after obtaining the biopsy. Such treatments include:
  • Scraping and burning (curettage and cauterization). After numbing with local anesthetic, the area is scraped with a sharp instrument (a curette) and burned with an electric needle (cautery).
  • Silver nitrate solution
  • Topical imiquimod cream (Aldara)
  • Laser treatment
  • Freezing with liquid nitrogen (cryotherapy)
  • Surgical removal (excision)
Approximately 40% of lobular capillary hemangiomas come back (recur) after treatment, especially those lesions located on the trunk of teenagers and young adults. Recurrent lobular capillary hemangiomas are best treated by surgical excision.


Bolognia, Jean L., ed. Dermatology, pp.1823-1824. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed, pp.1003, 1009. New York: McGraw-Hill, 2003.
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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
A medical illustration showing key findings of Lobular capillary hemangioma : Developed acutely , Friable papule, Hemorrhagic skin lesion, Red color
Clinical image of Lobular capillary hemangioma - imageId=163970. Click to open in gallery.  caption: 'A close-up of a well-demarcated bleeding papule.'
A close-up of a well-demarcated bleeding papule.
Copyright © 2023 VisualDx®. All rights reserved.