CONJUNCTIVAL PYOGENIC GRANULOMA

Published 2023 - 27th ESCRS Winter Meeting

Reference: P144 | Type: Presented Poster & Poster Submission | DOI: 10.82333/p22b-p870

Authors: Salma Hassina* ¹ , mohammed amine krichene ¹ , hasnaoui ihssane ¹ , chaimaa bardi ¹ , lobna robbana ¹ , TLEMCANI YOUNES ¹ , louay serghini ¹ , abdellah elhassan ¹ , amina berraho ¹

¹ophtalmology B,CHU IBN SINA,RABAT,Morocco

Purpose

A pyogenic granuloma is characterized as a pedunculated vascular lesion, and appears as a fleshy red or pink mass. It is often located on the eyelid and bleeds easily with minimal contact. Clinically, it arises with rapid growth in an area of previous trauma, surgery, or inflammation. Histologically, it is composed of granulation tissue, capillaries, and non-granulomatous inflammatory cells . Recommended treatment is excision of the lesion at it's base.

Setting

We report the case of a young boy with a conjonctival lesion

Methods

We report the case of a 6 year old boy with notion of trauma 5 months ago by vegetal thorn who presented to the emergency room with a conjunctival lesion on his right eyelid appeared for 4 months which was small and progressively increasing in size. The examination objective:vision was 7 / 10, a bright red mass, vascularized, with a large base on his right upper tarsal conjunctival

Cornea was bright. Iris had normal colour and pattern. The pupil was of normal size reacting to light. No changes in lens seen, left eye was normal.

the child was put under topical treatment with loteprednol etabonate 0.5% for 1 month, the size of the mass had slightly decreased. Two months after stopping the treatment, the mass had decreased by one third. Hence the need for surgery: removal of the lesion.

Results

Pyogenic granulomas are vascular lesions commonly occurring on skin and mucosa, including the palpebral conjunctiva. The exact etiology is unknown, but the granuloma is often associated with a chalazion, a hordeolum, or a history of trauma or surgery.

Pyogenic granuloma presents as a nontender, fleshy, red, vascular lesion.The lesions are typically sessile or pedunculated, are dome-shaped, and vary from 1 to 10 mm in diameter. The mass is a collection of granulation tissue such as chronic inflammatory cells, fibroblasts, and endothelial cells of budding capillaries .Most pyogenic granulomas are asymptomatic .Pyogenic granulomas rarely resolve spontaneously. If they are asymptomatic, no treatment is necessary.

The response to topical therapies varies among patients from a decrease in size to full resolution or no effect at all. Topical corticosteroids prescribed 4 times a day for 1 to 2 weeks may reduce the lesions.However, there may be no response at all. If the lesion persists, surgical excision is required.Removal of a single pedunculated lesion is done using a shave excision and electrocautery. Recurrence is uncommon with surgical excision, but the risk rises when granulation tissue remains.

Conclusion

Though pyogenic granuloma is relatively a common condition,it has to be differentiated from other lesions with similar clinical presentation, with appropriate treatment modalities it yields excellent results and should not be missed.