HEAD AND NECK PYOGENIC GRANULOMAS IN CHILDREN

Pyogenic granuloma (PG) is a benign, acquired, vascular neoplasm of the skin and mucous membranes. Papules develop most commonly on the head, neck, and extremities, especially the fingers and periungual area. Minimal trauma often triggers profuse bleeding that is difficult to control, leading to a visit to the emergency room. Treatments vary and include surgical excision with primary closure, shave excision at the base. Recurrences and development of multiple satellite lesions after therapy can achieve. In the period between January 2008 and December 2010, 32 patients underwent to PG excision at the Pediatric Surgery Unit, S Anna Hospital, Ferrara, Italy. Patients included 12 (37.5%) females and 20 (62.5%) males. Age ranged from 5 months to 15 years with a mean value of 6 years at the time of admission. 6, 9, and 10 PGs where located in the lower, middle and upper third of the face, respectively. 7 PGs were in the neck. PGs were treated with surgical excision: 24 under general anesthesia, 3 under sedation and 5 under local anesthesia. Many different treatments have been used for PG, with variable success rates. The several approaches have been: excisional surgery, cryosurgery, curettage, laser, injection of ethanol or corticosteroid and sodium tetradecyl sulfate sclerotherapy. However, full-thickness surgical excision has been considered as the standard treatment. In our series all PGs were surgically removed and no recurrences were detected thereafter. Consequently surgical treatment is an effective method to treat this lesion.