Pyogenic granuloma is a common benign vascular tumour occurring in all ages. Both skin and mucous membranes can be affected. Of pathogenetic importance are trauma, BRAF mutations and probably herpes virus type 1, Orf virus and/or human papilloma virus type 2. The tumour consists of capillary proliferations, venules and fibromyxoid stroma. The development of a lesion occurs in three stages and bleeding is a common symptom. The tumour can mimic various other vascular lesions, solid tumours, and soft tissue infections. In recent years, targeted tumour therapies have become the most common cause of drug-induced pyogenic granulomas. The backbone of treatment is surgical procedures including laser therapy. New developments in medical drug therapy include topical and systemic beta-adrenergic receptor antagonists timolol and propranolol. Drug therapy is an alternative for young children, ocular and periungual pyogenic granuloma.

/pdf/pyogenic-granuloma-a-common-benign-vascular-tumor-with-bwpoqb5ivd.pdf

Pyogenic Granuloma – A Common Benign Vascular Tumor with Variable Clinical Presentation: New Findings and Treatment Options

Summary

Background Spider leg veins are a common aesthetic problem in females. The standard treatment is sclerotherapy but lasers have been used for decades to solve this problem as well.



Aim  To review recent advances in laser physics and its tissue interactions with skin vessels. The different laser types used to treat spider leg veins are discussed, including their advantages, limitations and possible adverse effects.



Method  The international literature on laser therapy for spider leg veins has been reviewed with particular emphasis on the last decade.



Results  Recent developments in laser technology allow a more selective and well-tolerated therapy. Efficacy has also improved. Most studies report a greater than 75% improvement in spider leg veins as a realistic goal for laser therapy. Clinic response depends upon wavelength, fluence, pulse width and pulse duration, cooling and the diameter and colour of spider leg veins.



Conclusions  Sclerotherapy remains the gold standard treatment for spider leg veins. Nevertheless, laser therapy has become increasingly efficacious and convenient. Laser selectivity has been improved by technological progress. The ideal laser, however, has yet to be invented.

Laser therapy of spider leg veins.

Cherry hemangioma (CH) is an extremely frequent dermatosis with vascular origin involving more than 75% of the population over 70 years of age. Normally they are multiplex spots and focus predominantly on the upper trunk and arms. Clinically they are characterized by pinpoint maculae and papules with up to 5 millimeters in diameter. The most recent lesions can be a strong red color while the older ones are bluish. The etiology of CH is still unknown. From the histologic standpoint, the neoformation of the capillary tube draws attention: they are very dilated and with fenestration along the wall. The basement membranes are thickened and there is abundant collagen stroma between the veins. This work demonstrates the high frequency of CH in the scalp. In a sample of 171 patients (85 men and 86 women) the author noted that 123 (72%) had CH in the scalp. However, according to the literature, CH in the scalp has never been described.

http://www.scielo.br/pdf/abd/v79n1/en_19998.pdf

Hemangioma rubi no couro cabeludo

A typical eruptive capillary hemangioma developed at the margin of an argon laser-treated nevus flammeus. The relationship of argon laser-induced vascular reactions to eruptive capillary hemangioma is discussed.

Eruptive capillary hemangioma following argon laser therapy of naevus flammeus

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Eruptive capillary hemangioma following argon laser therapy of naevus flammeus