![]() ![]() Some vessels were congested and lined by plump endothelial cells. Dermis revealed lobules of variably sized capillaries in a fibromyxoid matrix with admixed inflammatory cells. Microscopic examination showed a vascular lesion surrounded by hyperplastic epithelium with parakeratosis and focal ulceration. The excised lesion was sent to National Institute of Pathology for histopathology. The lesion recurred two times despite excision. Our presumptive diagnosis was pyogenic granuloma or an infected acrochordon over a nevus flammeus. The growth was non-pruritic with occasional episodic spontaneous bleeding. We hereby report an unusual case of spontaneously recurrent pyogenic ranuloma within a nevus flammeus in the absence of any predisposing factor and further discuss their relationship with arteriovenous malformations.Ī 26-year-old male presented to us with a single, 2 × 3 cm dark red, dome-shaped pedunculated growth within a congenital, Diffuse pale red patch extending irregularly over the left upper thigh. This spontaneous development may be promoted by arteriovenous anastomoses in vascular lesions, especially in the richly vascularized areas like fingers, hands, lips, tongue and face leading to the development ofpyogenic ranuloma. Few of them have arisen in nevus flammeus without any predisposing factor like trauma, laser treatment, or pregnancy. The occurrence of recurrent pyogenic granuloma in association with such vascular lesions is rare. Various vascular neoplasms like capillary hemangiomas, tufted angiomas, and cavernous hemangiomas, have been rarely associated with port-wine stain (PWS), also a type of nevus flammeus. It has been infrequently reported in association with other vascular abnormalities such as nevus flammeus and vascular hemangiomas, especially after laser therapy. Pyogenic granuloma is an acquired reactive vascular proliferation in the skin and oral mucosa, commonly affecting the children and young adults. ![]()
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