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      Pyogenic granuloma on the upper lip: an unusual location

      case-report

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          Abstract

          Pyogenic granuloma (PG) is a benign non-neoplastic mucocutaneous lesion. It is a reactional response to constant minor trauma and might be related to hormonal changes. In the mouth, PG is manifested as a sessile or pedunculated, resilient, erythematous, exophytic and painful papule or nodule with a smooth or lobulated surface that bleeds easily. PG preferentially affects the gingiva, but may also occur on the lips, tongue, oral mucosa and palate. The most common treatment is surgical excision. This paper describes a mucocutaneous PG on the upper lip, analyzing the clinical characteristics and discussing the features that distinguish this lesion from other similar oral mucosa lesions. The diagnosis of oral lesions is complex and leads the dentist to consider distinct lesions with different diagnostic methods. This case report with a 4 year-follow-up calls the attention to the uncommon mucocutaneous labial location of PG and to the fact that surgical excision is the safest method for diagnosis and treatment of PG of the lip, even when involving the mucosa and skin

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          Most cited references30

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          Oral pyogenic granuloma: a review.

          Pyogenic granuloma is one of the inflammatory hyperplasias seen in the oral cavity. This term is a misnomer because the lesion is unrelated to infection and in reality arises in response to various stimuli such as low-grade local irritation, traumatic injury or hormonal factors. It predominantly occurs in the second decade of life in young females, possibly because of the vascular effects of female hormones. Clinically, oral pyogenic granuloma is a smooth or lobulated exophytic lesion manifesting as small, red erythematous papules on a pedunculated or sometimes sessile base, which is usually hemorrhagic. The surface ranges from pink to red to purple, depending on the age of the lesion. Although excisional surgery is the treatment of choice for it, some other treatment protocols such as the use of Nd:YAG laser, flash lamp pulsed dye laser, cryosurgery, intralesional injection of ethanol or corticosteroid and sodium tetradecyl sulfate sclerotherapy have been proposed. Because of the high frequency of pyogenic granuloma in the oral cavity, especially during pregnancy, and necessity for proper diagnosis and treatment, a complete review of published information and investigations about this lesion, in addition to knowledge about new approaches for its treatment is presented.
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            Oral pyogenic granuloma in Jordanians: a retrospective analysis of 108 cases.

            The purpose of the present study was to retrospectively analyze the clinicopathologic features and treatment of oral pyogenic granuloma in Jordanian patients. Information regarding 108 cases of pyogenic granuloma of the oral cavity that underwent biopsy were retrieved from the records of patients seen at the maxillofacial and periodontology units of the Faculty of Dentistry, Jordan University of Science and Technology, during an 11-year period from 1991 to 2001. Data were reviewed and analyzed for age, gender, site, treatment, and clinical and histopathologic features. Patient ages ranged from 3 to 85 years (mean, 30 years), with the greatest degree of occurrence (26.8%) in the second decade. The male-to-female ratio was 1:1.7. The mean age for females age was higher than that for males. The most frequently involved site was the gingiva (44.4%); other sites were the lips, tongue, buccal mucosa, and palate. Gingival pyogenic granulomas were more prevalent in the maxilla than in the mandible, with the anterior region of both jaws being more commonly affected. The labiobuccal gingiva of both jaws was more commonly affected. The main complaint was bleeding (59.3%), and almost half of the lesions had a pedunculated base, with surface ulceration in 9.2% of cases. The mean greatest granuloma diameter was 10 mm. All lesions were surgically excised, with 5.8% of cases known to have recurred. The clinicopathologic features of oral pyogenic granuloma in Jordanians are similar to those of other whites. In this series, we found that with surgical excision of pyogenic granuloma, there was a low recurrence rate.
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              Oral pyogenic granuloma: a review of 137 cases.

              G Saravana (2009)
              We retrospectively reviewed 137 cases of histologically confirmed pyogenic granuloma of the oral cavity from the records of the Department of Oral Surgery, Bharat Heavy Electricals Hospital, Trichy, India between 1996 and 2006. The most commonly affected site was the gingiva (n=114, 83%). Mean age of patients was 31 years (range 6-85, male to female ratio 1:2.6). Simple excision is enough to prevent recurrence, but the aetiology and pathogenesis of the lesion must be known to understand its nature.
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                Author and article information

                Journal
                J Appl Oral Sci
                J Appl Oral Sci
                Journal of Applied Oral Science
                Faculdade de Odontologia de Bauru da Universidade de São Paulo
                1678-7757
                1678-7765
                Sep-Oct 2010
                Sep-Oct 2010
                : 18
                : 5
                : 538-541
                Affiliations
                [1 ] DDS, PhD, Assistant Professor, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
                [2 ] DDS, PhD, Professor, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
                [3 ] DDS, PhD in Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
                [4 ] DDS, PhD, Associate Professor, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
                Author notes
                Corresponding address: Eduardo Sanches Gonçales - Faculdade de Odontologia de Bauru - USP - Departmento de Estomatologia - Al. Dr. Octavio Pinheiro Brisolla 9-75 - 17.012-901 - Bauru, SP - Brasil - Phone: 55 14 32358250 - e-mail: eduardogoncales@ 123456usp.br
                Article
                10.1590/S1678-77572010000500019
                4246389
                21085814
                4125e864-7c0e-4fc0-a2ed-ec14b61de855

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 March 2009
                : 16 September 2009
                : 11 October 2009
                Categories
                Case Report

                pyogenic granuloma,pregnancy tumor,chemically induced

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