Diagnostic Considerations

Also consider the following:

Amelanotic melanoma (pyogenic granuloma)
Amyloidosis
Annular elastolytic granuloma
Annular lichen planus
Bacillary angiomatosis (pyogenic granuloma)
Creeping eruption
Erythema annulare centrifugum
Erythema chronicum migrans
Erythema elevatum diutinum
Fibrosarcoma (pyogenic granuloma)
Granuloma multiforme
Kaposi sarcoma
Lipoid proteinosis
Majocchi granuloma
Malignant melanoma (pyogenic granuloma) ^[8]
Metastatic lesions (pyogenic granuloma)
Necrobiosis lipoidica
Peripheral giant cell granuloma (pyogenic granuloma)
Peripheral ossifying fibroma (pyogenic granuloma)
Ringworm
Rheumatoid nodules
Squamous cell carcinoma (pyogenic granuloma)
Subacute lupus erythematosus
Tuberculous granulomas
Verrucous carcinoma (pyogenic granuloma)
Verruca plana
Xanthomas

Differential Diagnoses

Workup

Kamal R, Dahiya P, Puri A. Oral pyogenic granuloma: Various concepts of etiopathogenesis. J Oral Maxillofac Pathol. 2012 Jan. 16(1):79-82. [QxMD MEDLINE Link]. [Full Text].
Spicuzza L, Salafia S, Capizzi A, Vitaliti G, Rotolo N, Leonardi S, et al. Granuloma annulare as first clinical manifestation of diabetes mellitus in children: a case report. Diabetes Res Clin Pract. 2012 Mar. 95(3):e55-7. [QxMD MEDLINE Link].
Ziemer M, Grabner T, Eisendle K, Baltaci M, Zelger B. Granuloma annulare - a manifestation of infection with Borrelia?. J Cutan Pathol. 2008 Jun 18. [QxMD MEDLINE Link].
Scott PL, Motaparthi K, Krishnan B, Hsu S. Pyogenic granuloma-like Kaposi sarcoma: a diagnostic pitfall. Dermatol Online J. 2012 Mar 15. 18(3):4. [QxMD MEDLINE Link].
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].
Krishnapillai R, Punnoose K, Angadi PV, Koneru A. Oral pyogenic granuloma-a review of 215 cases in a South Indian Teaching Hospital, Karnataka, over a period of 20 years. Oral Maxillofac Surg. 2012 Jan 26. [QxMD MEDLINE Link].
Charollais R, Aubin F, Roche-Kubler B, Puzenat E. [Two cases of granuloma annulare under anti-PD1 therapy]. Ann Dermatol Venereol. 2018 Feb. 145 (2):116-119. [QxMD MEDLINE Link].
Moshe M, Levi A, Ad-El D, Ben-Amitai D, Mimouni D, Didkovsky E, et al. Malignant melanoma clinically mimicking pyogenic granuloma: comparison of clinical evaluation and histopathology. Melanoma Res. 2018 Aug. 28 (4):363-367. [QxMD MEDLINE Link].
Thornsberry LA, English JC 3rd. Etiology, diagnosis, and therapeutic management of granuloma annulare: an update. Am J Clin Dermatol. 2013 Aug. 14(4):279-90. [QxMD MEDLINE Link].
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].
Wine Lee L, Goff KL, Lam JM, Low DW, Yan AC, Castelo-Soccio L. Treatment of pediatric pyogenic granulomas using β-adrenergic receptor antagonists. Pediatr Dermatol. 2014 Mar-Apr. 31 (2):203-7. [QxMD MEDLINE Link].
Pagliai KA, Cohen BA. Pyogenic granuloma in children. Pediatr Dermatol. 2004 Jan-Feb. 21(1):10-3. [QxMD MEDLINE Link].
Looney M, Smith KM. Isotretinoin in the treatment of granuloma annulare. Ann Pharmacother. 2004 Mar. 38(3):494-7. [QxMD MEDLINE Link].
Weber HO, Borelli C, Rocken M, Schaller M. Treatment of disseminated granuloma annulare with low-dose fumaric acid. Acta Derm Venereol. 2009. 89(3):295-8. [QxMD MEDLINE Link].
Werchau S, Enk A, Hartmann M. Generalized interstitial granuloma annulare--response to adalimumab. Int J Dermatol. 2010 Apr. 49(4):457-60. [QxMD MEDLINE Link].

Media Gallery

Granuloma annulare. Courtesy of Wikimedia Commons (Mierlo at English Wikipedia).
Pyogenic granulomas are usually solitary lesions. The fingers and hands are common locations for these to develop. A history of minor trauma at the site shortly before development of the lesion is frequent.