Will pyogenic granuloma on scalp bleed on scratching?

Question

Hello doctor,

I would like to ask about a nodule on my scalp. In the past, I have been told it is a pyogenic granuloma in a consultation, but it has not been biopsied. The nodule has grown in size in the past three months.

Is it possible for a pyogenic granuloma to become less pigmented over time?

I have included images for your reference. The nodule was previously very pink and would bleed if scratched.

Additionally, I had a hemangioma on my chest as an infant, which was surgically excised.

Kindly help.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

I have seen the image (attachment removed to protect patient identity) and read your given history.

From both, it looks like a pyogenic granuloma itself. Be aware that the causes of its development are bacterial/fungal infection, trauma induced following minor injuries and abrasions, hormonal imbalance, or drug induced due to certain drugs like oral retinoids.

The color of pyogenic granuloma lesions can vary anywhere between pale red to red to brown because the lesions involve underlying capillaries and blood vessels. For the same reason, it bleeds on touch and can bleed occasionally.

Since the lesion has been present for three months and is increasing in size, the best option to consider would be surgical excision biopsy, where after the excision the lesion would be sent to test for malignant potential (highly unlikely) just to be sure of things. Other options to consider are laser-assisted removal, cryotherapy, and cauterization.

Topical therapy with cream of imiquimod (immune modifier) and cream of propranolol (beta-2 adrenergic blocker) is available, but it has a poor response, as it may take a long period of time. As I mentioned earlier, an excision biopsy would be the best option for you.

And seeing the image, there is no reason to worry about it after the excision.

I hope this helps.

Thank you.