Pyogenic Granuloma (Lobular Capillary Hemangioma) Questions & Answers

1. Mills SE, Cooper PH, Fechner RE. Lobular capillary hemangioma: the underlying lesion of pyogenic granuloma. A study of 73 cases from the oral and nasal mucous membranes. Am J Surg Pathol. 1980 Oct. 4(5):470-9. [QxMD MEDLINE Link].

2. Chen SY, Takeuchi S, Urabe K, et al. Overexpression of phosphorylated-ATF2 and STAT3 in cutaneous angiosarcoma and pyogenic granuloma. J Cutan Pathol. 2008 Aug. 35(8):722-30. [QxMD MEDLINE Link].

3. Vassilopoulos SI, Tosios KI, Panis VG, Vrotsos JA. Endothelial cells of oral pyogenic granulomas express eNOS and CD105/endoglin: an immunohistochemical study. J Oral Pathol Med. 2011 Apr. 40(4):345-51. [QxMD MEDLINE Link].

4. Vasconcelos MG, Alves PM, Vasconcelos RG, da Silveira ÉJ, Medeiros AM, de Queiroz LM. Expression of CD34 and CD105 as markers for angiogenesis in oral vascular malformations and pyogenic granulomas. Eur Arch Otorhinolaryngol. 2011 Aug. 268(8):1213-7. [QxMD MEDLINE Link].

5. Godfraind C, Calicchio ML, Kozakewich H. Pyogenic granuloma, an impaired wound healing process, linked to vascular growth driven by FLT4 and the nitric oxide pathway. Mod Pathol. 2013 Feb. 26(2):247-55. [QxMD MEDLINE Link].

6. Isaza-Guzmán DM, Teller-Carrero CB, Laberry-Bermúdez MP, González-Pérez LV, Tobón-Arroyave SI. Assessment of clinicopathological characteristics and immunoexpression of COX-2 and IL-10 in oral pyogenic granuloma. Arch Oral Biol. 2012 May. 57(5):503-12. [QxMD MEDLINE Link].

7. Groesser L, Peterhof E, Evert M, Landthaler M, Berneburg M, Hafner C. BRAF and RAS Mutations in Sporadic and Secondary Pyogenic Granuloma. J Invest Dermatol. 2016 Feb. 136 (2):481-6. [QxMD MEDLINE Link].

8. Lim YH, Douglas SR, Ko CJ, Antaya RJ, McNiff JM, Zhou J, et al. Somatic Activating RAS Mutations Cause Vascular Tumors Including Pyogenic Granuloma. J Invest Dermatol. 2015 Jun. 135 (6):1698-700. [QxMD MEDLINE Link].

9. Motegi SI, Fujiwara C, Yamazaki S, Sekiguchi A, Ishikawa O. Possible contribution of autophagy in pyogenic granuloma. J Dermatol. 2018 Sep. 45 (9):1145-1146. [QxMD MEDLINE Link].

10. El Hayderi L, Paurobally D, Fassotte MF, André J, Arrese JE, Sadzot-Delvaux C, et al. Herpes simplex virus type-I and pyogenic granuloma: a vascular endothelial growth factor-mediated association?. Case Rep Dermatol. 2013. 5(2):236-43. [QxMD MEDLINE Link]. [Full Text].

11. Vázquez-Martínez OT, González-Betancourt A, Barboza-Cerda MC, González-González SE, Lugo-Trampe Á, Welsh O, et al. Human papillomavirus type 2 associated with pyogenic granuloma in patients without clinical evidence of warts. Int J Dermatol. 2015 Oct 22. [QxMD MEDLINE Link].

12. Truss L, Dobin SM, Donner LR. Deletion (21)(q21.2q22.12) as a sole clonal cytogenetic abnormality in a lobular capillary hemangioma of the nasal cavity. Cancer Genet Cytogenet. 2006 Oct 1. 170(1):69-70. [QxMD MEDLINE Link].

13. Patrice SJ, Wiss K, Mulliken JB. Pyogenic granuloma (lobular capillary hemangioma): a clinicopathologic study of 178 cases. Pediatr Dermatol. 1991 Dec. 8(4):267-76. [QxMD MEDLINE Link].

14. Sills ES, Zegarelli DJ, Hoschander MM, Strider WE. Clinical diagnosis and management of hormonally responsive oral pregnancy tumor (pyogenic granuloma). J Reprod Med. 1996 Jul. 41(7):467-70. [QxMD MEDLINE Link].

15. Harris MN, Desai R, Chuang TY, Hood AF, Mirowski GW. Lobular capillary hemangiomas: An epidemiologic report, with emphasis on cutaneous lesions. J Am Acad Dermatol. 2000 Jun. 42(6):1012-6. [QxMD MEDLINE Link].

16. Alexander AM Jr, Koh JK. Granuloma pyogenicum (pyogenic granuloma) causing severe anemia. Arch Dermatol. 1972 Jul. 106(1):128. [QxMD MEDLINE Link].

17. Azzopardi EA, Xuereb CB, Iyer S. Pyogenic granuloma as a surrogate indicator of deep seated foreign bodies: a case report. Cases J. 2009 Aug 5. 2:7354. [QxMD MEDLINE Link]. [Full Text].

18. Lee J, Sinno H, Tahiri Y, Gilardino MS. Treatment options for cutaneous pyogenic granulomas: a review. J Plast Reconstr Aesthet Surg. 2011 Sep. 64(9):1216-20. [QxMD MEDLINE Link].

19. Piraccini BM, Bellavista S, Misciali C, Tosti A, de Berker D, Richert B. Periungual and subungual pyogenic granuloma. Br J Dermatol. 2010 Nov. 163(5):941-53. [QxMD MEDLINE Link].

20. Rodins K, Gramp D, James D, Kumar S. Pyogenic granuloma, port-wine stain and pregnancy. Australas J Dermatol. 2011 Nov. 52(4):e8-e10. [QxMD MEDLINE Link].

21. Cheah S, DeKoven J. Pyogenic granuloma complicating pulsed-dye laser therapy for cherry angioma. Australas J Dermatol. 2009 May. 50(2):141-3. [QxMD MEDLINE Link].

22. Liu S, Yang C, Xu S, Yuan C, Yang S, Zhang X. Pyogenic granuloma arising as a complication of 595 nm tunable pulsed dye laser treatment of port-wine stains: report of four cases. Dermatol Surg. 2010 Aug. 36(8):1341-3. [QxMD MEDLINE Link].

23. Campbell JP, Grekin RC, Ellis CN, Matsuda-John SS, Swanson NA, Voorhees JJ. Retinoid therapy is associated with excess granulation tissue responses. J Am Acad Dermatol. 1983 Nov. 9(5):708-13. [QxMD MEDLINE Link].

24. Badri T, Hawilo AM, Benmously R, Fenniche S, Mokhtar I. Acitretin-induced pyogenic granuloma. Acta Dermatovenerol Alp Panonica Adriat. 2011 Dec. 20(4):217-218. [QxMD MEDLINE Link].

25. Teknetzis A, Ioannides D, Vakali G, Lefaki I, Minas A. Pyogenic granulomas following topical application of tretinoin. J Eur Acad Dermatol Venereol. 2004 May. 18(3):337-9. [QxMD MEDLINE Link].

26. Bouscarat F, Bouchard C, Bouhour D. Paronychia and pyogenic granuloma of the great toes in patients treated with indinavir. N Engl J Med. 1998 Jun 11. 338(24):1776-7. [QxMD MEDLINE Link].

27. Wu PA, Balagula Y, Lacouture ME, Anadkat MJ. Prophylaxis and treatment of dermatologic adverse events from epidermal growth factor receptor inhibitors. Curr Opin Oncol. 2011 Jul. 23(4):343-51. [QxMD MEDLINE Link].

28. Curr N, Saunders H, Murugasu A, Cooray P, Schwarz M, Gin D. Multiple periungual pyogenic granulomas following systemic 5-fluorouracil. Australas J Dermatol. 2006 May. 47(2):130-3. [QxMD MEDLINE Link].

29. Piguet V, Borradori L. Pyogenic granuloma-like lesions during capecitabine therapy. Br J Dermatol. 2002 Dec. 147(6):1270-2. [QxMD MEDLINE Link].

30. Freiman A, Bouganim N, O'Brien EA. Case reports: mitozantrone-induced onycholysis associated with subungual abscesses, paronychia, and pyogenic granuloma. J Drugs Dermatol. 2005 Jul-Aug. 4(4):490-2. [QxMD MEDLINE Link].

31. Devillers C, Vanhooteghem O, Henrijean A, Ramaut M, de la Brassinne M. Subungueal pyogenic granuloma secondary to docetaxel therapy. Clin Exp Dermatol. 2009 Mar. 34(2):251-2. [QxMD MEDLINE Link].

32. Paul LJ, Cohen PR. Paclitaxel-associated subungual pyogenic granuloma: report in a patient with breast cancer receiving paclitaxel and review of drug-induced pyogenic granulomas adjacent to and beneath the nail. J Drugs Dermatol. 2012 Feb. 11(2):262-8. [QxMD MEDLINE Link].

33. Sibaud V, Dalenc F, Mourey L, Chevreau C. Paronychia and pyogenic granuloma induced by new anticancer mTOR inhibitors. Acta Derm Venereol. 2011 Sep. 91(5):584-5. [QxMD MEDLINE Link].

34. Sammut SJ, Tomson N, Corrie P. Pyogenic granuloma as a cutaneous adverse effect of vemurafenib. N Engl J Med. 2014 Sep 25. 371(13):1265-7. [QxMD MEDLINE Link].

35. Paurobally D, Andre J, Richert B. Nail Pyogenic Granuloma following Treatment with Blinatumomab. Skin Appendage Disord. 2018 Apr. 4 (2):96-97. [QxMD MEDLINE Link].

36. Ibe T, Hamamoto Y, Takabatake M, Kamoshida S. Development of pyogenic granuloma with strong vascular endothelial growth factor receptor-2 expression during ramucirumab treatment. BMJ Case Rep. 2019 Nov 26. 12 (11):[QxMD MEDLINE Link].

37. Higgins EM, Hughes JR, Snowden S, Pembroke AC. Cyclosporin-induced periungual granulation tissue. Br J Dermatol. 1995 May. 132(5):829-30. [QxMD MEDLINE Link].

38. Suarez-Amor O, Cabanillas M, Monteagudo B, de Las Heras C, Cacharron JM. [Disseminated pyogenic granuloma induced by erythropoietin?]. Actas Dermosifiliogr. 2009 Jun. 100(5):439-40. [QxMD MEDLINE Link].

39. Vergara A, Isarria MJ, Rodriguez-Peralto JL, Guerra A. [Disseminated lobular capillary hemangiomas]. Actas Dermosifiliogr. 2008 Jul-Aug. 99(6):494-6. [QxMD MEDLINE Link].

40. Keles MK, Yosma E, Aydogdu IO, Simsek T, Park TH. Multiple Subungual Pyogenic Granulomas Following Levothyroxine Treatment. J Craniofac Surg. 2015 Sep. 26 (6):e476-7. [QxMD MEDLINE Link].

41. Wollina U. Multiple eruptive periungual pyogenic granulomas during anti-CD20 monoclonal antibody therapy for rheumatoid arthritis. J Dermatol Case Rep. 2010 Dec 19. 4(3):44-6. [QxMD MEDLINE Link]. [Full Text].

42. Patruno C, Balato N, Cirillo T, Napolitano M, Ayala F. Periungual and subungual pyogenic granuloma following anti-TNF-a therapy: is it the first case?. Dermatol Ther. 2013 Nov-Dec. 26(6):493-5. [QxMD MEDLINE Link].

43. Johnson TM, Demsar WJ, Herold RW, Bisch FC, Gerlach RC, Swiec GD. Pyogenic granuloma occurring in a postmenopausal woman on hormone replacement therapy. US Army Med Dep J. 2011 Jan-Mar. 86-90. [QxMD MEDLINE Link].

44. Qadir SN, Manzur A, Raza N. Multiple disseminated pyogenic granulomas. J Coll Physicians Surg Pak. 2013 Aug. 23(8):588-9. [QxMD MEDLINE Link].

45. Browning JC, Eldin KW, Kozakewich HP, Mulliken JB, Bree AF. Congenital disseminated pyogenic granuloma. Pediatr Dermatol. 2009 May-Jun. 26(3):323-7. [QxMD MEDLINE Link].

46. Palmero ML, Pope E. Eruptive pyogenic granulomas developing after drug hypersensitivity reaction. J Am Acad Dermatol. 2009 May. 60(5):855-7. [QxMD MEDLINE Link].

47. Netchiporouk E, Moreau L, Ramirez LP, Castillo PA, Bravo FP, Del Solar MC, et al. Eruptive Disseminated Pyogenic Granulomas following Lightning Injury. Dermatology. 2015 Feb 18. [QxMD MEDLINE Link].

48. Nthumba PM. Giant pyogenic granuloma of the thigh: a case report. J Med Case Reports. 2008 Mar 31. 2:95. [QxMD MEDLINE Link]. [Full Text].

49. Zaynoun ST, Juljulian HH, Kurban AK. Pyogenic granuloma with multiple satellites. Arch Dermatol. 1974 May. 109(5):689-91. [QxMD MEDLINE Link].

50. Cooper PH, Mills SE. Subcutaneous granuloma pyogenicum. Lobular capillary hemangioma. Arch Dermatol. 1982 Jan. 118(1):30-3. [QxMD MEDLINE Link].

51. Sirka CS, Rout AN, Sahu K. Linear papular pyogenic granuloma: An unusual presentation. Indian J Dermatol Venereol Leprol. 2020 Jan 8. [QxMD MEDLINE Link].

52. Cooper PH, McAllister HA, Helwig EB. Intravenous pyogenic granuloma. A study of 18 cases. Am J Surg Pathol. 1979 Jun. 3(3):221-8. [QxMD MEDLINE Link].

53. Jose RM, Bennett A, Holmes J. Spitz naevi presenting as pyogenic granulomata. Br J Plast Surg. 2005 Oct. 58(7):1037-9. [QxMD MEDLINE Link].

54. Cordoro KM, Gupta D, Frieden IJ, McCalmont T, Kashani-Sabet M. Pediatric melanoma: results of a large cohort study and proposal for modified ABCD detection criteria for children. J Am Acad Dermatol. 2013 Jun. 68(6):913-25. [QxMD MEDLINE Link].

55. Schade AT, Raymond AC, Amirfeyz R. If it is not healing, do worry about it!. BMJ Case Rep. 2013 Jan 10. 2013:[QxMD MEDLINE Link].

56. Lee GK, Suh KJ, Lee JH, Lee JY, Yang I, Koh SH, et al. Lobular capillary hemangioma in the soft tissue of the finger: sonographic findings. Skeletal Radiol. 2010 Nov. 39(11):1097-102. [QxMD MEDLINE Link].

57. Kikusawa A, Oka M, Shimizu H, Tsujimoto M, Marui Y, Yokogawa S, et al. Subcutaneous lobular capillary hemangioma with sonography and computed tomography findings. Eur J Dermatol. 2012 Mar-Apr. 22(2):276-7. [QxMD MEDLINE Link].

58. Zaballos P, Carulla M, Ozdemir F, Zalaudek I, Bañuls J, Llambrich A, et al. Dermoscopy of pyogenic granuloma: a morphological study. Br J Dermatol. 2010 Dec. 163(6):1229-37. [QxMD MEDLINE Link].

59. Żychowska M. Dermoscopic rainbow pattern - now also in pyogenic granuloma. Int J Dermatol. 2020 Mar. 59 (3):369-370. [QxMD MEDLINE Link].

60. Zaballos P, Rodero J, Serrano P, Cuellar F, Guionnet N, Vives JM. Pyogenic granuloma clinically and dermoscopically mimicking pigmented melanoma. Dermatol Online J. 2009 Oct 15. 15(10):10. [QxMD MEDLINE Link].

61. Moscarella E, Zalaudek I, Agozzino M, Vega H, Cota C, Catricalà C, et al. Reflectance confocal microscopy for the evaluation of solitary red nodules. Dermatology. 2012. 224(4):295-300. [QxMD MEDLINE Link].

62. Waraasawapati S, Koonmee S, Kusama H, Kudo M. Extramedullary hematopoiesis in pyogenic granuloma. Pathol Int. 2013 Oct. 63(10):492-5. [QxMD MEDLINE Link].

63. Trindade F, Tellechea O, Torrelo A, Requena L, Colmenero I. Wilms tumor 1 expression in vascular neoplasms and vascular malformations. Am J Dermatopathol. 2011 Aug. 33(6):569-72. [QxMD MEDLINE Link].

64. North PE, Waner M, Mizeracki A, Mihm MC Jr. GLUT1: a newly discovered immunohistochemical marker for juvenile hemangiomas. Hum Pathol. 2000 Jan. 31(1):11-22. [QxMD MEDLINE Link].

65. Lacouture ME, Anadkat MJ, Bensadoun RJ, Bryce J, Chan A, Epstein JB. Clinical practice guidelines for the prevention and treatment of EGFR inhibitor-associated dermatologic toxicities. Support Care Cancer. 2011 Aug. 19(8):1079-95. [QxMD MEDLINE Link].

66. Wine Lee L, Goff KL, Lam JM, Low DW, Yan AC, Castelo-Soccio L. Treatment of pediatric pyogenic granulomas using ß-adrenergic receptor antagonists. Pediatr Dermatol. 2014 Mar-Apr. 31(2):203-7. [QxMD MEDLINE Link].

67. Khorsand K, Maier M, Brandling-Bennett HA. Pyogenic granuloma in a 5-month-old treated with topical timolol. Pediatr Dermatol. 2015 Jan-Feb. 32(1):150-1. [QxMD MEDLINE Link].

68. Yen CF, Hsu CK, Lu CW. Topical betaxolol for treating relapsing paronychia with pyogenic granuloma-like lesions induced by epidermal growth factor receptor inhibitors. J Am Acad Dermatol. 2018 Jun. 78 (6):e143-e144. [QxMD MEDLINE Link].

69. Baek YS, Kwon SH, Jeon J. Combination of ligation and timolol before surgical excision of pyogenic granuloma. J Am Acad Dermatol. 2018 Jun. 78 (6):e141-e142. [QxMD MEDLINE Link].

70. Mashiah J, Hadj-Rabia S, Slodownik D, Harel A, Sprecher E, Kutz A. Effectiveness of topical propranolol 4% gel in the treatment of pyogenic granuloma in children. J Dermatol. 2019 Mar. 46 (3):245-248. [QxMD MEDLINE Link].

71. Tritton SM, Smith S, Wong LC, Zagarella S, Fischer G. Pyogenic granuloma in ten children treated with topical imiquimod. Pediatr Dermatol. 2009 May-Jun. 26(3):269-72. [QxMD MEDLINE Link].

72. Maloney DM, Schmidt JD, Duvic M. Alitretinoin gel to treat pyogenic granuloma. J Am Acad Dermatol. 2002 Dec. 47(6):969-70. [QxMD MEDLINE Link].

73. Jung HJ, Eun DH, Kim JY, Lee WJ, Kim DW, Lee SJ, et al. Treatment of paediatric facial pyogenic granuloma with topical ingenol mebutate. Clin Exp Dermatol. 2017 Dec. 42 (8):912-913. [QxMD MEDLINE Link].

74. Ceyhan AM, Basak PY, Akkaya VB, Yildirim M, Kapucuoglu N. A case of multiple, eruptive pyogenic granuloma developed on a region of the burned skin: can erythromycin be a treatment option?. J Burn Care Res. 2007 Sep-Oct. 28(5):754-7. [QxMD MEDLINE Link].

75. Daruwalla SB, Dhurat RS. A pinch of salt is all it takes! - The novel use of table salt for the effective treatment of pyogenic granuloma. J Am Acad Dermatol. 2019 Dec 12. [QxMD MEDLINE Link].

76. Carvalho RA, Neto V. Letter: Polidocanol sclerotherapy for the treatment of pyogenic granuloma. Dermatol Surg. 2010 Jun. 36 Suppl 2:1068-70. [QxMD MEDLINE Link].

77. Quitkin HM, Rosenwasser MP, Strauch RJ. The efficacy of silver nitrate cauterization for pyogenic granuloma of the hand. J Hand Surg Am. 2003 May. 28(3):435-8. [QxMD MEDLINE Link].

78. Losa Iglesias ME, Becerro de Bengoa Vallejo R. Topical phenol as a conservative treatment for periungual pyogenic granuloma. Dermatol Surg. 2010 May. 36(5):675-8. [QxMD MEDLINE Link].

79. Lee DJ, Kim EH, Jang YH, Kim YC. Photodynamic therapy with 5-aminolevulinic acid intralesional injection for pyogenic granuloma. Arch Dermatol. 2012 Jan. 148(1):126-8. [QxMD MEDLINE Link].

80. Parisi E, Glick PH, Glick M. Recurrent intraoral pyogenic granuloma with satellitosis treated with corticosteroids. Oral Dis. 2006 Jan. 12(1):70-2. [QxMD MEDLINE Link].

81. Tursen U, Demirkan F, Ikizoglu G. Giant recurrent pyogenic granuloma on the face with satellitosis responsive to systemic steroids. Clin Exp Dermatol. 2004 Jan. 29(1):40-1. [QxMD MEDLINE Link].

82. Daya M. Complete resolution of a recurrent giant pyogenic granuloma on the palm of the hand following single dose of intralesional bleomycin injection. J Plast Reconstr Aesthet Surg. 2010 Mar. 63(3):e331-3. [QxMD MEDLINE Link].

83. Ghodsi SZ, Raziei M, Taheri A, Karami M, Mansoori P, Farnaghi F. Comparison of cryotherapy and curettage for the treatment of pyogenic granuloma: a randomized trial. Br J Dermatol. 2006 Apr. 154(4):671-5. [QxMD MEDLINE Link].

84. Tsai KY, Wang WH, Chang GH, Tsai YH. Treatment of pregnancy-associated oral pyogenic granuloma with life-threatening haemorrhage by transarterial embolisation. J Laryngol Otol. 2015 Jun. 129 (6):607-10. [QxMD MEDLINE Link].

85. Jakhar D, Kaur I. Trap technique for bloodless removal of digital pyogenic granuloma. J Am Acad Dermatol. 2019 Apr 13. [QxMD MEDLINE Link].

86. Yang C, Liu S. Treatment of giant pyogenic granuloma with the Nd/YAG holmium laser: a case report. J Cosmet Laser Ther. 2013 Aug. 15(4):225-7. [QxMD MEDLINE Link].

87. Asnaashari M, Mehdipour M, MoradiAbbasabadi F, Azari-Marhabi S. Expedited removal of pyogenic granuloma by diode laser in a pediatric patient. J Lasers Med Sci. 2015 Winter. 6(1):40-4. [QxMD MEDLINE Link]. [Full Text].

88. Fekrazad R, Nokhbatolfoghahaei H, Khoei F, Kalhori KA. Pyogenic Granuloma: Surgical Treatment with Er:YAG Laser. J Lasers Med Sci. 2014 Fall. 5(4):199-205. [QxMD MEDLINE Link]. [Full Text].

89. Zeng H, Yang R, Ding Y. Use of a water-cooled Nd: YAG pulsed laser in the treatment of giant gingival pyogenic granulomas during pregnancy. J Stomatol Oral Maxillofac Surg. 2019 Jun 1. [QxMD MEDLINE Link].

90. Just U, Hinterhuber G, Knobler R, Neumann R. A potassium-titanyl-phosphate laser is an efficacious tool in the treatment of pyogenic granulomas. A retrospective study in 28 patients. Photochem Photobiol Sci. 2019 Feb 13. 18 (2):343-348. [QxMD MEDLINE Link].

91. Holbe HC, Frosch PJ, Herbst RA. Surgical pearl: ligation of the base of pyogenic granuloma--an atraumatic, simple, and cost-effective procedure. J Am Acad Dermatol. 2003 Sep. 49(3):509-10. [QxMD MEDLINE Link].

92. Mirshams M, Daneshpazhooh M, Mirshekari A, Taheri A, Mansoori P, Hekmat S. Cryotherapy in the treatment of pyogenic granuloma. J Eur Acad Dermatol Venereol. 2006 Aug. 20(7):788-90. [QxMD MEDLINE Link].

93. Manus DA, Sherbert D, Jackson IT. Management considerations for the granuloma of pregnancy. Plast Reconstr Surg. 1995 May. 95(6):1045-50. [QxMD MEDLINE Link].

Joseph C Pierson, MD Dermatology Residency Program Director, University of Vermont College of Medicine

Joseph C Pierson, MD is a member of the following medical societies: Association of Professors of Dermatology, New England Dermatological Society, American Academy of Dermatology

Disclosure: Nothing to disclose.

Christine C Tam, MD Managing Member, Certified Dermatologists

Christine C Tam, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Donald Belsito, MD Professor of Clinical Dermatology, Department of Dermatology, Columbia University Medical Center

Donald Belsito, MD is a member of the following medical societies: New York County Medical Society, Noah Worcester Dermatological Society, Phi Beta Kappa, American Contact Dermatitis Society, Dermatology Foundation, Dermatologic Society of Greater New York, Alpha Omega Alpha, American Academy of Dermatology

Disclosure: Nothing to disclose.

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Diane Pierson, DO, to the development and writing of this article.

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