Dermoscopy of pyogenic granuloma: A morphological study

P. Zaballos, M. Carulla, F. Ozdemir, I. Zalaudek, J. Baíuls, A. Llambrich, S. Puig, G. Argenziano, J. Malvehy

Research output: Contribution to journalArticlepeer-review


Summary Background Pyogenic granuloma is a common, benign, vascular lesion of the skin and mucous membranes which is a simulator of amelanotic/ hypomelanotic melanoma and other tumours. Objectives To determine the diagnostic significance of dermoscopic structures and patterns associated with pyogenic granulomas in a large series of cases. Methods Digital dermoscopic images of histopathologically proven cases of 122 pyogenic granulomas and 140 other tumours (28 amelanotic melanomas, seven melanoma metastases, 22 basal cell carcinomas and 83 other tumours) were collected from university hospitals in Spain, Italy, Austria and Turkey. The frequency, sensitivity, specificity, positive predictive value, negative predictive value, intraobserver agreement and interobserver agreement of the dermoscopic structures and patterns associated with pyogenic granulomas were calculated. Results Vascular structures were observed in 45% of pyogenic granulomas (sensitivity of 45·1% and specificity of 17·9%; both P <0·001). Seven exclusive patterns were made up from the combination of the structures 'reddish homogeneous area' (RHA), 'white collarette' (WC), 'white rail lines' (WRL) and 'vascular structures' (VS). The pattern composed of RHA, WC and WRL showed the highest sensitivity (22·1%; P <0·001) and a specificity of 100% (P <0·001) for pyogenic granulomas. Two other patterns (RHA + WC and RHA + WC + WRL + VS) showed 100% specificity when compared with melanoma (P <0·001 and P <0·05, respectively). Conclusions Even though some dermoscopic patterns are useful in the recognition of pyogenic granulomas, dermoscopy is not a substitute for histology, mostly when vessels are present, as melanoma cannot be ruled out.

Original languageEnglish
Pages (from-to)1229-1237
Number of pages9
JournalBritish Journal of Dermatology
Issue number6
Publication statusPublished - Dec 2010


  • amelanotic melanoma
  • dermoscopy
  • pyogenic granuloma

ASJC Scopus subject areas

  • Dermatology


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