Lobular capillary hemangioma in Adult
See also in: External and Internal Eye,Hair and Scalp,Nail and Distal Digit,Oral Mucosal LesionAlerts and Notices
Synopsis
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).
Codes
ICD10CM:L98.0 – Pyogenic granuloma
SNOMEDCT:
200722003 – Pyogenic granuloma
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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.Subscription Required
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Last Reviewed:11/14/2017
Last Updated:08/12/2021
Last Updated:08/12/2021
Patient Information for Lobular capillary hemangioma in Adult
Overview
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
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).Treatments
If the diagnosis of lobular capillary hemangioma is suspected, your doctor will probably want to perform a skin biopsy. The procedure involves:- Numbing the skin with an injectable anesthetic.
- 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.
- Having the skin sample examined under the microscope by a specially trained physician (dermatopathologist).
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)
References
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.
Lobular capillary hemangioma in Adult
See also in: External and Internal Eye,Hair and Scalp,Nail and Distal Digit,Oral Mucosal Lesion