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Case Reports in Dentistry 2024Pyogenic granuloma (PG) is a well-known tumor-like growth that commonly appears in the gingiva of the oral cavity. This reactive lesion can develop in response to local...
Pyogenic granuloma (PG) is a well-known tumor-like growth that commonly appears in the gingiva of the oral cavity. This reactive lesion can develop in response to local irritation, chronic low-grade trauma, long-term low-grade infection, or hormonal imbalances. PG is more frequently observed in individuals during their second and third decades of life, although it can occur at any age. It is more prevalent in young females than males, but on rare occasions, it can be found in children, even infants. Several treatment options exist for PG lesions, which apply after a final diagnosis specified by biopsy and histopathological investigations. Surgical excision is the most common treatment choice for PG lesions. However, comparisons between laser therapy and surgical excision have shown numerous advantages for laser treatment, making it a preferred option for soft tissue lesions. Laser excision offers benefits such as precise and deep incisions, preservation of sterile conditions, improved hemostasis, avoidance of sutures, and less invasive procedures resulting in reduced intra- and postoperative discomfort, pain, and bleeding. This report is aimed at presenting a case of an 11-month-old infant with a gradually growing pyogenic granuloma (PG) lesion that appeared in the palate behind the upper left first deciduous tooth, with a duration of approximately 2 months. The parents reported a history of bleeding associated with the lesion, which emerged after the eruption of the mandibular tooth. An excisional biopsy was done by the application of an 810 nm diode laser under general anesthesia, and the specimen was evaluated by a pathologist. No posttreatment complications or relapses were observed in this case.
PubMed: 38274320
DOI: 10.1155/2024/6668716 -
Cureus Dec 2023Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer that can present with various clinical manifestations. An 80-year-old male, known to have chronic...
Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer that can present with various clinical manifestations. An 80-year-old male, known to have chronic lymphocytic leukaemia presented with a lesion on his left thumb, initially thought to be a pyogenic granuloma. The lesion was cauterized with silver nitrate but remained persistent. A curettage biopsy was performed, and a histopathological examination revealed MCC. The patient was subsequently referred to dermatology and plastic surgery for further management. The lesion was excised; a full-thickness skin graft was used to close the defect. This case highlights the importance of considering MCC in the differential diagnosis of skin lesions, even if they present with a benign appearance.
PubMed: 38249166
DOI: 10.7759/cureus.50878 -
Skin Research and Technology : Official... Jan 2024The clinical differential diagnosis of lesions arising on the eyelid margin may be challenging and an unneeded surgical approach may have serious functional and...
BACKGROUND
The clinical differential diagnosis of lesions arising on the eyelid margin may be challenging and an unneeded surgical approach may have serious functional and aesthetic consequences. Nonetheless, early recognition and treatment of malignant tumors of the eyelid margin is mandatory. Line-field confocal optical coherence tomography (LC-OCT) is a novel tool for the in vivo, real-time skin imaging.
OBJECTIVES
The aim of the study was to identify and analyze the LC-OCT features of a series of eyelid margin growths and to correlate these features with the histopathological findings.
METHODS
Patients with eyelid margin growths who were scheduled for lesion excision underwent LC-OCT examination. Inclusion criteria were a challenging clinical aspect of the lesions and a clinical history of recent onset (up to 12 months). In all cases, the histopathological examination of the excised lesions was performed for the final diagnosis.
RESULTS
A total of 31 lesions located on the upper (13 cases) or lower (18 cases) eyelid margin from 28 consecutive patients (male = 15, female = 13; mean age: 64.7 years, range: 44-87 years) were evaluated and excised. The histopathologic diagnoses were nodular basal cell carcinoma (BCC) (nine cases), squamous cell carcinoma (SCC) (three cases), compound nevus (four cases), dermal nevus (two cases), seborrheic keratosis (four cases), pyogenic granuloma (one case), trichilemmal cyst (three cases), and hidrocystoma (five cases). LC-OCT allowed the in vivo recognition of the main microscopic features of the examined lesions.
CONCLUSIONS
LC-OCT represents a promising tool for the evaluation of eyelid margin lesions. Advantages of non-invasive diagnosis particularly relevant in such a sensitive region include a more correct planning of the treatment and, in case of surgery, the most appropriate surgical approach and, importantly, a correct timing of intervention.
Topics: Humans; Male; Female; Middle Aged; Skin Neoplasms; Tomography, Optical Coherence; Carcinoma, Basal Cell; Eyelids; Nevus
PubMed: 38174775
DOI: 10.1111/srt.13559 -
Cureus Nov 2023Pyogenic granuloma is a non-neoplastic inflammatory reactive hyperplasia commonly found on keratinized tissues caused by different factors such as hormonal imbalance....
Pyogenic granuloma is a non-neoplastic inflammatory reactive hyperplasia commonly found on keratinized tissues caused by different factors such as hormonal imbalance. Pyogenic granuloma has a wide age range and is frequently found in females in the second to third decade. Pyogenic granuloma developed in pregnancy is commonly known as pregnancy tumor. The standard treatment approach is surgical excision of the lesion. In the case report, a 42-year-old female presented with a persistent oral lesion in the left anterior mandible. The lesion first appeared during pregnancy and remained in the oral cavity for two years after delivery. Clinical, radiographic, and histopathological examination revealed a definitive diagnosis of pyogenic granuloma.
PubMed: 38143621
DOI: 10.7759/cureus.49326 -
International Journal of Molecular... Nov 2023Pyogenic granuloma (PG) is a benign vascular lesion found predominantly in the oral cavity. Characterized by rapid growth and propensity to bleed, PG presents diagnostic... (Review)
Review
Pyogenic granuloma (PG) is a benign vascular lesion found predominantly in the oral cavity. Characterized by rapid growth and propensity to bleed, PG presents diagnostic challenges due to its similarity and alarming proliferation. This narrative review synthesizes current knowledge on the epidemiology, etiopathogenesis, clinical manifestations, and management of oral PG, with emphasis on recent advances in diagnostic and therapeutic approaches. The epidemiology of the injury is meticulously analyzed, revealing a higher incidence in women and a wide range of ages of onset. It delves into the etiopathogenesis, highlighting the uncertainty surrounding the exact causal factors, although historical attributions suggest an infectious origin. It exhaustively analyzes the clinical and histopathological aspects of oral PG, offering information on its various presentations and the importance of an accurate diagnosis to guide effective treatment. It details treatment strategies, emphasizing the personalized approach based on individual patient characteristics. This comprehensive review consolidates current knowledge on oral PG, highlighting the need for further research to clarify its pathogenesis and optimize treatment protocols.
Topics: Humans; Female; Granuloma, Pyogenic; Mouth Mucosa; Mouth
PubMed: 38069207
DOI: 10.3390/ijms242316885 -
Cureus Nov 2023An inflammatory hyperplasia known as a pyogenic granuloma (PG) appears as a nodular growth on the oral mucosa. The most frequent place is the gingiva, followed by the...
An inflammatory hyperplasia known as a pyogenic granuloma (PG) appears as a nodular growth on the oral mucosa. The most frequent place is the gingiva, followed by the buccal mucosa, tongue, and lips. Histologically, the surface epithelium may be hyperkeratotic, have ulceration foci, or be intact. It lies on the dense connective tissue that contains a sizable amount of fully developed collagen. Most of the pregnancies result in PG of the gingiva; for this reason, the phrases "Pregnancy Tumor" and "Granuloma Gravidarum" are frequently used. It typically occurs during the second and third months of pregnancy and tends to bleed, making it challenging to masticate. Estrogen increases the vascular endothelial growth factor (VEGF) synthesis in macrophages, which is associated with PG development during pregnancy. This case describes a surgically treated case of PG in a middle-aged female with a conventional scalpel technique, giving functional and esthetic outcomes in a patient.
PubMed: 38058325
DOI: 10.7759/cureus.48305 -
Nigerian Journal of Clinical Practice Nov 2023A study of oral vascular anomalies has not been conducted in Nigeria to provide baseline data for comparison with reports in the literature. (Observational Study)
Observational Study
BACKGROUND
A study of oral vascular anomalies has not been conducted in Nigeria to provide baseline data for comparison with reports in the literature.
AIMS
To study the prevalence and distribution of benign orofacial vascular anomalies at a tertiary hospital in Enugu.
MATERIALS AND METHODS
This is a 10-year retrospective observational study of consecutive patients with orofacial vascular anomalies, diagnosed by histology. The clinic-pathologic information was obtained from records archived in the department, and descriptive analysis was used to determine the frequency, tables for categorical variables, and a Chi-square test to determine the statistical significance.
RESULT
There were 47 cases of benign vascular anomalies out of 897 orofacial lesions giving a prevalence of 5.2%. There were 35.4% (17) male and 64.6% (31) female patients. The mean age in this series was 37.4 ± 19.8 (range: 1 to 76 years). Pyogenic granuloma was the most common vascular lesion 78.7% (37), followed by hemangioma 14.9% (7) and lymphangioma 6.4% (3). The gingiva was the most frequent site of oral occurrence 65.9% (31), especially maxillary gingivae 48.9% (23). The type of orofacial vascular anomalies was significantly associated with the anatomical site of occurrence, P = 0.00. The mean ages for the occurrence of pyogenic granuloma, hemangioma, and lymphangioma were 37.7 ± 18.3, 50.7 ± 16.9 years, and 3.3 ± 3.2 years, respectively. Pain was a frequent occurrence in 36.2% (17) of anomalies.
CONCLUSION
Oral vascular anomalies predominantly presented as pyogenic granuloma on the gingivae, while oral hemangioma was observed in adults, and lymphangioma was infrequent.
Topics: Adult; Humans; Male; Female; Infant; Child, Preschool; Child; Adolescent; Young Adult; Middle Aged; Aged; Granuloma, Pyogenic; Nigeria; Hemangioma; Gingiva; Retrospective Studies; Lymphangioma
PubMed: 38044779
DOI: 10.4103/njcp.njcp_332_23 -
Journal of Lasers in Medical Sciences 2023Lasers in oral surgery have been extensively studied in recent years. Laser treatment is now a well-known technology that is frequently employed on oral soft tissues.... (Review)
Review
Lasers in oral surgery have been extensively studied in recent years. Laser treatment is now a well-known technology that is frequently employed on oral soft tissues. The carbon dioxide (CO2) laser was one of the first soft tissue removal lasers. Because of the strong affinity of the CO2 laser to water, it is best used for removing, vaporizing, and coagulating these tissues. In minor oral surgery, CO2 laser therapy has shown advantages. Therefore, this study examined the CO2 laser use in minor oral soft tissue surgery. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were followed in this study. A question for research encompassing the inclusion criteria for the participants, intervention, comparison, outcome, and study design (PICOS) was formulated. The search queries were entered into the PubMed/Medline, Scopus, and Embase databases. Consideration was given to publications published between January 1, 2018 and March 15, 2023. The research included 37 studies after narrowing search results, eliminating duplicate titles, and conducting an eligibility review (three animal studies, seven case reports, three case series, and twenty-four clinical studies). CO2 lasers alone or in combination with other therapies successfully treated oral potentially malignant disorders (OPMDs), oral tumors, oral fibrous-epithelial lesions, gingival melanin hyperpigmentation, pyogenic granuloma, socket preservation, mucocele, high labial frenulum attachment, and so on. CO2 lasers reduced intra- and postoperative complications and adverse effects, improved postoperative functional results, ablated tissues with precision, and minimized disease recurrence and malignant transformation. Our study found that the CO2 laser in oral minor surgeries is successful, but further randomized clinical trials and multicenter studies are recommended to compare CO2 laser surgery to other treatments.
PubMed: 38028885
DOI: 10.34172/jlms.2023.44 -
Cureus Oct 2023Pyogenic granuloma is a common reactive oral lesion primarily found in the gingiva and rarely in extraction sockets. While it can develop at any age, it is more...
Pyogenic granuloma is a common reactive oral lesion primarily found in the gingiva and rarely in extraction sockets. While it can develop at any age, it is more prevalent in the third and fourth decades of life with a higher occurrence in females. Various factors contribute to its development and surgical removal is the gold standard treatment; however, there are various other methods available. This case report documents a rare event in which a female patient in her early 40s presented with an exophytic lesion affecting the extraction socket of her maxillary right lateral incisor. The lesion was effectively removed through surgical excision. Additionally, it explores the clinical features and pathogenesis of this lesion. The purpose of this case report is to shed light on the uncommon incidence of pyogenic granuloma following tooth extraction. This non-neoplastic vascular growth often presents as an erythematous, ulcerated lesion with a tendency to bleed, with either a sessile or pedunculated base. Our case is one of only five instances documented in the literature, underscoring the importance of knowledge and timely response in such unusual circumstances. We emphasize the significance of early detection and management for improved patient outcomes and a better understanding of this rare condition.
PubMed: 37933368
DOI: 10.7759/cureus.46592 -
Journal of Feline Medicine and Surgery Oct 2023The aim of this study was to determine whether an association existed between cephalometric measurements, maxillomandibular dental arch distances and the occurrence of...
OBJECTIVES
The aim of this study was to determine whether an association existed between cephalometric measurements, maxillomandibular dental arch distances and the occurrence of traumatic malocclusions in the mandibular soft tissues of cats.
METHODS
Cats that had presented for dental consultations and that underwent cone-beam CT during diagnostic assessment were included in the study and categorised as cases and controls in a 1:2 ratio. Cases were designated as cats with a clinical diagnosis of malocclusion causing trauma to the buccal mandibular soft tissues or pyogenic granuloma secondary to the trauma, and controls were designated as cats with the absence of such diagnoses and without a history of other musculoskeletal anomalies in the head. Cephalometric measurements, including skull and facial indexes, as well as distances and angulations between dental crowns and crown tips, were calculated and analysed statistically.
RESULTS
In total, 72 cats (24 cases and 48 controls) were included in the study. Cephalometric measurements revealed a significant association between the skull and facial indexes and the occurrence of traumatic malocclusions in the caudal teeth. Brachycephaly was a strong predictor of the occurrence of traumatic malocclusions. In addition, the space between crown tips and teeth angulations was a contributing factor to the trauma.
CONCLUSIONS AND RELEVANCE
Cats with traumatic malocclusions in the cheek teeth tend to present a narrower interdental space between the maxillary and mandibular carnassial teeth, mostly attributed to skeletal and dental malocclusion. These findings can be used to help raise awareness about this disease in cats and its association with brachycephaly. Cut-off values have been proposed and could be used in the selection of cats by breeders to reduce the occurrence of this disease.
Topics: Cats; Animals; Retrospective Studies; Case-Control Studies; Mandible; Malocclusion; Craniosynostoses; Cat Diseases
PubMed: 37906203
DOI: 10.1177/1098612X231202322