Pyogenic Granuloma Arising Within a Port-wine Stain
Pyogenic granulomas are common overgrowths of vascular tissue that usually arise on the face, lips, or hands after episodes of minor trauma or during pregnancy. Pyogenic granulomas rarely have been reported to arise in congenital capillary malformations such as port-wine stains, a presentation that most often occurs after laser treatment of port-wine stains or in the setting of pregnancy. This co-occurrence of the 2 lesions represents an underreported event, and the presentation can be alarming or mimic malignancy when there is no prior history of trauma or other known circumstances in which pyogenic granulomas occur. We report a case of a pyogenic granuloma emerging within a port-wine stain in a 35-year-old man with no predisposing factors. A review of the literature regarding pyogenic granulomas that arise within port-wine stains is presented and yields informative conclusions regarding the clinical scenarios where this sometimes alarming event is likely to happen.
Pyogenic granuloma is a well-known and probably underreported complication of port-wine stains. Unlike thickening and nodule formation that tend to occur in port-wine stains in the trigeminal nerve distribution, pyogenic granulomas arising in port-wine stains tend to occur more commonly on the neck, trunk, or extremities. The pyogenic granuloma should not be confused with a true malignancy because it represents hyperplasia of vascular tissue in response to trauma, but the performance of an excisional biopsy is warranted.
