Curettage and punch excision of the vascular base: an effective method for treatment of pyogenic granuloma with excellent results

Background: There are different treatment options with variable results for the management of pyogenic granuloma (PG). The aim of this study was to evaluate and compare the cosmetic results and recurrence rate of classic surgical excision with a novel proposed method, curettage and punch excision of the vascular stalk (C&P) in patients diagnosed as PG. Method: Forty consecutive cases of PG (20 with hand and 20 with facial lesions) were randomized into 2 treatment groups (total excision vs. C&P). The patients were visited by another physician who was blind to the method to evaluate the recurrence of the lesions and measure the scar size. Result: Thirty-eight cases completed the study. There was only one recurrence in the hand C&P group that was not statistically significant when compared with the hand excision group (P < 0.05). The mean scar size in the cases with total excision was significantly larger than the C&P group (P < 0.001). Also, there were no detectable scars in 72% of the cases who underwent C&P. Conclusion: It seems that our proposed method, i.e. C&P, is an effective option in the treatment of PG with a very low recurrence rate and more favorable cosmetic results.