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Monday, October 27, 2014

Pyogenic granulomas of the vulva (yuck)



Pyogenic granuloma (also known as an "eruptive hemangioma", "granulation tissue-type hemangioma", "lobular capillary hemangioma" or "pregnancy tumor") is a type of lesion that commonly occurs on the mucosa or skin, usually on the trunk or limbs. The growths are red with a smooth or lobulated surface, usually painless or slightly tender, and bleed easily after minor trauma. They are completely benign. The cause is tissue overgrowth due to chronic local irritation, physical trauma or hormonal factors.

Pyogenic granulomas on the vulva are a relatively rare finding. An article from 2011 describes a 57-year-old woman who had several lesions of this sort in her genital area. She sought medical help after three years of suffering from foul-smelling, cherry red growths on her labia and clitoris. The lumps itched badly and had a tendency to bleed easily. Here's an icky photo:


 
Pyogenic granuloma of the vulva: a 2-cm lesion at the upper intersection of the labia majora, a 2-cm lesion on the right labium majus and a 4-cm lesion on the clitoris.
Image from: Arikan et al. (2011)


A tissue smear and Gram smear from the lesions did not reveal any organisms. Serological tests for herpes, syphilis, and human immune deficiency viruses were also negative.The lesions were all excised and sent for histopathological examination, which revealed an ulcerated polypoidal structure with extensive proliferation of vascular channels lined by a single layer of endothelium. Pyogenic granuloma was diagnosed. The cause was probably chronic irritation of the genital area because of persistent itching associated with menopause.


Source:

Arikan DC, Kiran G, Sayar H, Kostu B, Coskun A, Kiran H. (2011) Vulvar Pyogenic Granuloma in a Postmenopausal Woman: Case Report and Review of the Literature. Case Rep Med. 2011: 201901. 




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