Abstract

Background and Aim: Pyogenic granuloma (PG) is a commonly acquired benign vascular neoplasm that presents as a rapidly growing red nodule. Several conditions can mimic PG clinically, leading to misdiagnosis and inappropriate treatment. Our study aims to characterize the distinguishing features between PG and non-PG lesions and to evaluate the prevalence of PG misdiagnosis.
Methods: A retrospective analysis, using histopathology reports from patients clinically diagnosed with PG between 2018 and 2024. Statistical analysis was performed using STATA software, employing both chi-square and Fisher’s exact tests to evaluate significant associations.
Results: A total of 47 cases were analyzed. Among the 47 clinically diagnosed PG cases, 22 (46.8%) were reclassified as non-PG upon histopathological evaluation. The most common misdiagnoses were non-melanoma skin cancers (13%), followed by vascular neoplasms (11%). PG cases showed a significant association with bleeding tendency (84% of PG cases vs. 50% of non-PG cases), while ulceration was more prevalent in non-PG lesions (12% of PG cases vs. 50% of non-PG cases).
Conclusion: Our findings suggest that older age, longer lesion duration, absence of bleeding, and the presence of ulceration are key clinical features predictive of non-PG cases.

Key words: Histopathology; Lobular capillary hemangioma; Pyogenic granuloma; Skin cancer; Vascular neoplasm