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Drugs in Context 2019Nail toxicities, such as paronychia and pyogenic granuloma-like lesions, are well-recognized side effects of epidermal growth factor receptor inhibitor (EGFR-I) therapy... (Review)
Review
Nail toxicities, such as paronychia and pyogenic granuloma-like lesions, are well-recognized side effects of epidermal growth factor receptor inhibitor (EGFR-I) therapy that can significantly impair patient's quality of life and compliance to anticancer treatment. Numerous therapeutic options are available, with variable rates of success. Recently, topical β-blockers have emerged as a novel, non-invasive treatment strategy. We tested the effectiveness of topical timolol 0.5% gel, twice daily, under occlusion for 30 days, on paronychia and periungual pyogenic granuloma-like lesions in 9 patients being treated with EGFR-I. We also reviewed the available literature on this topic, which is the use of topical β-blockers in the management of EGFR-I-induced nail toxicities. We assessed 25 lesions consistent with the diagnosis of EGFR-I-induced pyogenic granuloma-like lesions and paronychia (21 diagnosed as pyogenic granuloma-like, and four as paronychia). Thirteen of the 25 lesions achieved complete resolution, 9/25 reached at least improvement, and only 3/25 did not respond to the intervention. As for the review, four papers met the scope of our research. The results confirmed at least partial benefit in the majority of treated patients. Among current strategies, high-potency topical corticosteroids are a well-known treatment option especially for paronychia, targeting the inflammatory component of such lesions; nevertheless, the management of pyogenic granuloma-like lesion is often more complex and the success rate is variable. Nail plate avulsion and phenol chemical matricectomy are not highly effective and display some degree of invasiveness. Topical β-blockers seem to be promising alternatives, especially in fragile cancer patients who may be unsuitable candidates for an invasive procedure.
PubMed: 31798664
DOI: 10.7573/dic.212613 -
BMC Oral Health Apr 2021The aim of the present investigation was to evaluate the literature recurrence of peripheral giant cell granuloma and pyogenic granuloma associated with dental implants....
BACKGROUND
The aim of the present investigation was to evaluate the literature recurrence of peripheral giant cell granuloma and pyogenic granuloma associated with dental implants. It's important to know the characteristics present in these lesions and possible effects on the prognosis of dental implants.
METHODS
An electronic search without time restrictions was done in the databases: PubMed/Medline. With the keywords "Granuloma" OR "Granuloma, Giant Cell" OR "peripheral giant cell" OR "Granuloma, Pyogenic" AND "Dental implants" OR "Oral implants".
RESULTS
After applying the inclusion and exclusion criteria, a total of 20 articles were included, which reported 32 lesions (10 pyogenic granulomas, 21 peripheral giant cell granulomas and one peripheral giant cell granuloma combined with peripheral ossifying fibroma, all associated with implants). According to our review, these lesions are more frequent in males and in the posterior region of the mandible. Both excision and curettage of the lesion, compared to only excision, presented similar recurrences (40%). Explantation of the implant was performed in 41% of cases without additional recurrences. The results are not statistically significant when comparing one lesion to the other in terms of explantation (p = 0.97), recurrence (p = 0.57) or bone loss (p = 0.67).
CONCLUSIONS
The main therapeutic approach is tissue excision. The lesions show a high recurrence rate (34.4%), which often requires explantation of the associated implant. This recurrence rate is not affected by curettage after excision.
Topics: Dental Implants; Granuloma, Giant Cell; Granuloma, Pyogenic; Humans; Male; Neoplasm Recurrence, Local; Prevalence
PubMed: 33892689
DOI: 10.1186/s12903-021-01566-4 -
Canadian Family Physician Medecin de... Jul 2023
Topics: Humans; Granuloma, Pyogenic; Treatment Outcome
PubMed: 37451992
DOI: 10.46747/cfp.6907479 -
Journal of Dental Sciences Sep 2018Peculiar findings of orofacial actinomycosis mimicking the clinical appearance of a tumor of the upper gingiva are reported. An 83-year-old man with bleeding of the...
Peculiar findings of orofacial actinomycosis mimicking the clinical appearance of a tumor of the upper gingiva are reported. An 83-year-old man with bleeding of the gingiva visited our hospital. The clinical diagnosis was a benign gingival tumor, and the lesion was surgically removed. Histologically, the excised specimens showed an ulcerative granuloma lesion covered by bacterial colonies consisting of club-shaped filaments. DNA samples were extracted from paraffin sections and examined by polymerase chain reaction (PCR) for species. The PCR products examined by direct DNA sequencing demonstrated the presence of . Finally, a pathological diagnosis was made of a pyogenic granuloma associated with actinomycosis. The PCR method aided the early and exact diagnosis of the paraffin-embedded sample of oral mucosal infectious diseases including actinomycosis.
PubMed: 30895135
DOI: 10.1016/j.jds.2012.09.026 -
Ear, Nose, & Throat Journal Nov 2022Pyogenic granuloma is a benign vascular tumor of the skin or mucous membrane. One-third of pyogenic granulomas have been reported in the head and neck, but it is rarely...
Pyogenic granuloma is a benign vascular tumor of the skin or mucous membrane. One-third of pyogenic granulomas have been reported in the head and neck, but it is rarely present in the external auditory canal. Pyogenic granuloma mostly presents as a solitary granuloma, and only a few cases of multiple forms have been reported. This report describes a rare case of multiple pyogenic granulomas in the external auditory canal of a 36-year-old man along with a review of the literatures. Although it is very rare for PGs to occur in the EAC, it can be suspected in conditions such as after acute and/or chronic trauma, hormonal changes or systemic drug administration, rapid growth, and easy bleeding tendency with a friable surface. Some PGs may spontaneously resolve, but when they cause symptoms, excision is recommended for treatment and diagnosis. In the case of excision, the tumor should be excised down to the perichondrium level to prevent recurrence. Although PG mainly occurs in a solitary form, the present case shows a new clinical variation where multiple PGs were present in the EAC.
PubMed: 36433695
DOI: 10.1177/01455613221142734 -
Clinical, Cosmetic and Investigational... 2015Port-wine stains are a type of capillary malformation affecting 0.3% to 0.5% of the population. Port-wine stains present at birth as pink to erythematous patches on the... (Review)
Review
Port-wine stains are a type of capillary malformation affecting 0.3% to 0.5% of the population. Port-wine stains present at birth as pink to erythematous patches on the skin and/or mucosa. Without treatment, the patches typically darken with age and may eventually develop nodular thickening or associated pyogenic granuloma. Laser and light treatments provide improvement through selective destruction of vasculature. A variety of vascular-selective lasers may be employed, with the pulsed dye laser being the most common and well studied. Early treatment produces more optimal results. Advances in imaging and laser treatment technologies demonstrate potential to further improve clinical outcomes.
PubMed: 25624768
DOI: 10.2147/CCID.S53118 -
Indian Journal of Dermatology,... 2022Introduction Pyogenic granulomas are benign vascular lesions of the skin and mucosa which are often a source of concern because of their recurrent bleeding even with... (Randomized Controlled Trial)
Randomized Controlled Trial
Introduction Pyogenic granulomas are benign vascular lesions of the skin and mucosa which are often a source of concern because of their recurrent bleeding even with minimal trauma. Current treatment for pyogenic granuloma is ablative; no medical therapy is standardized to date. Timolol, due to its vasoconstrictive effect, vascular growth factor inhibition and apoptosis promotion properties, is a potential therapeutic option. Objectives: To assess the effectiveness and safety of topical timolol in the treatment of pyogenic granulomas. Methods A two-centre, double-blind and placebo-controlled trial (Registration CTRI/2019/04/018581) was conducted. Patients of either sex were recruited with pyogenic granuloma lesions of less than eight weeks duration. Topical treatment with 0.5% timolol or matching glycerin placebo was continued for six weeks. Changes in color, size, bleeding tendency, physicians' and patients' global assessments and adverse events were assessed. Results Forty subjects were randomized between the two groups which were comparable in age, sex, duration of illness and baseline lesion size.Significant improvement was noted with timolol, with color change from first follow-up onwards and lesion size reduction from second follow-up onward. Patients' assessment of bleeding tendency also showed imrovement from the second visit onward. Between-group comparison showed significant difference with respect to percentage reduction in size (timolol 40.9%, placebo 3.4%; P = 0.002). Rescue treatment (electrosurgery) was required in five patients on placebo and in one in the timolol group (P = 0.182). Complete resolution occurred in 2 (10%) patients with timolol and in no patients on placebo (P = 0.231). Limitations: We observed effects of treatment for only six weeks. Conclusion Topical timolol may be a treatment option for early pyogenic granulomas but complete resolution is unlikely in six weeks. Studies of longer duration are required to assess resolution and recurrence rates.
Topics: Administration, Topical; Adrenergic beta-Antagonists; Double-Blind Method; Granuloma, Pyogenic; Humans; Timolol
PubMed: 34672473
DOI: 10.25259/IJDVL_565_20 -
International Journal of Burns and... 2022Pyogenic granuloma (PG) is a benign vascular proliferative tumor of the skin and mucous membranes, it can appear spontaneously or following triggering factors. Different...
Pyogenic granuloma (PG) is a benign vascular proliferative tumor of the skin and mucous membranes, it can appear spontaneously or following triggering factors. Different clinical aspects are described, pyogenic granulomas following burns (GB) are rare. We report a case of post-burn pyogenic granuloma confirmed by histological study and treated surgically. This new observation will allow us to further clarify this condition.
PubMed: 35891973
DOI: No ID Found -
Turkish Journal of Medical Sciences Oct 2019Pyogenic granuloma (PG)-like nodular Kaposi’s sarcoma (KS) has been previously demonstrated in several studies. However, to the best of our knowledge, no original...
BACKGROUND/AIM
Pyogenic granuloma (PG)-like nodular Kaposi’s sarcoma (KS) has been previously demonstrated in several studies. However, to the best of our knowledge, no original study investigating the dermoscopic differential diagnosis of PG and KS exists in the relevant literature. In this study we aimed to identify dermoscopic findings providing useful clues to differential diagnosis between the two entities.
MATERIALS AND METHODS
Patients with histopathologically confirmed PG or nodular KS were included in the study. Demographic, clinical, dermoscopic, and histopathological findings of the cases were retrospectively reviewed.
RESULTS
The most common finding observed in PG was red structureless areas (80.00%), followed by intersecting thick white lines (56.66%), ulceration (36.66%), and collarette scale (33.33%). The most common findings detected in nodular KS were polychromatic structures (56.66%) and red (46.66%) and white (13.33%) structureless areas, respectively.
CONCLUSION
Intersecting thick white lines seem to be the strongest dermoscopic clue to PG. Striate surface scaling (n = 6) was a novel finding identified for PG. Here we also described a new vascular pattern (widespread vessels composing a network) for nodular KS.
Topics: Adolescent; Adult; Aged; Dermoscopy; Diagnosis, Differential; Female; Granuloma, Pyogenic; Humans; Male; Middle Aged; Retrospective Studies; Sarcoma, Kaposi; Skin Neoplasms; Young Adult
PubMed: 31651116
DOI: 10.3906/sag-1902-60 -
Endoscopy Nov 2022
Topics: Humans; Granuloma, Pyogenic; Gastritis
PubMed: 35120385
DOI: 10.1055/a-1730-4529