Lawrence Charles Parish, M.D.
Q: My son had a small cut on his chest. It healed up
quickly but now he has a
small lump that's red and
painful. Occasionally it will bleed a little. It seems to be getting bigger. What is it and should I worry about it?
A: It sounds as if your son has a pyogenic granuloma. (Pyogenic meaning caused by in fection; granuloma meaning growth of scar tissue). An other term for these lesions is "proud flesh." Even though "pyogenic" implies infection, it's now known that infection plays no role in their formation.
Pyogenic granulomas are generally small lesions (a quarter to half inch in diameter), usually occuring on the fingers, toes, lips, chest, or back. Less frequently, they are seen inside the mouth or rectal area.
They seem to develop quickly, usually within a few weeks of the injury, and, in some cases, bleed easily. Not all pyogenic granulomas are from trauma - some just appear. Pyogenic granulomas may be very tender, but some are totally pain free. They vary in color from red to black. Some are like bumps on the skin while others are more like a polyp with a narrow stalk. If irritated, they may crust over like a healing cut.
There are other possibilities: an irritated mole, a wart (verruca vulgaris), or even melanoma, a serious and potentially deadly type of skin cancer. Occasionally, an embedded tick might look like a pyogenic granuloma. Your child should see a doctor for a proper diagnosis.
Treatment is easy - removing the pygonic granuloma by snipping it off. Cryosurgery (using liquid nitrogen to freeze the lesion) is also recommended.
Pyogenic granulomas rarely recur. Scarring is very unlikely.
Lawrence Charles Parish, M.D., is a clinical professor of Dermatology and Cutaneous Biology and director of the Jefferson Center for International Dermatology, Jefferson Medical College, Philadelphia, PA. Please send your questions and comments to him care of Pediatrics for Parents, P.O. Box 63716, Philadelphia, PA 19147.
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