Online Photo Diagnosis

By Gregory W. DeNaeyer, OD, FAAO

A 13-year-old boy reported complaining of an irritation of his left lower lid that had been slowly worsening since his initial symptoms four weeks prior. Systemically he was healthy except for mild asthma, for which he did not take medication. He did not wear glasses or contact lenses and denied any history of trauma. The patient's visual acuity was 20/20 OS. The picture shows a lesion of his left lower cul-de-sac that was discovered upon examination. The lesion was excised, and the biopsy report suggested a pyogenic granuloma. The lesion recurred one month later, but was significantly smaller in size and the patient was asymptomatic.

Pyogenic granulomas are benign growths that most often occur in children, women who are pregnant, or in patients taking the drugs Indinavir, Soriatane, Accutane, and oral contraceptives. Trauma can precipitate their growth. They are very vascular and are prone to bleeding. Pyogenic granulomas can resolve on their own, but may need to be removed with curettage, chemicals, or surgical excision.

Reference

American Osteopathic College of Dermatology http://www.aocd.org/skin/dermatologic_diseases/pyogenic_granuloma.html