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Question: Derm

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You are seeing an 8 year old boy with the pictured lesion. He has had it for 2 months; it is slowly growing, and occasionally bleeds when irritated. It is not tender and he has no fever.

What is the best course of action?

pemsou5_wp • July 12, 2022

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  1. Kelly July 13, 2022 - 12:03 pm Reply

    B) Refer to dermatology for surgical excision
    The lesion pictured is a pyogenic granuloma. These are benign vascular tumors that often occur in areas of minor skin trauma, such as the face, arms, or hands. They may become pedunculated and may bleed or ulcerate. Propranolol is used for congenital hemangiomas, which would not present anew in an 8 year old. Silver nitrate is used for umbilical granulomas in neonates. Liquid nitrogen is used to treat common warts, which also commonly present on the finger in children, but which are not bright red and vascular. These are not associated with non-accidental trauma. Photo from

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