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Efficacy of Nd-YAG laser for treatment of pyogenic granuloma on the fingers and toes

  • J. Dong
  • S. G. Peng
  • X. Y. Zhang
  • C. G. Tong
  • F. Liu
  • M. Cao
  • Y. H. Li
  • Y. L. He
Original Article

Abstract

Pyogenic granuloma (PG) is a common benign vascular proliferation which often occurs on the head, neck, hands, and feet. Among the various treatment options for PG, surgical excision is the most effective treatment which offers the lowest overall recurrence rates and also provides the exact diagnosis. However, it could have difficulties to do the surgery when lesions are located on the fingers and toes, especially very near to the nails, so laser may be a very good alternative choice. In this article, we evaluated the clinical efficacy and safety of neodymium-yttrium aluminum garnet (Nd:YAG) laser for treatment of PG located on the fingers and toes. Twenty-one patients with 21 PGs located on the fingers and toes were treated by multispot Nd-YAG laser. We chose monopulse (pulse width 10.5–13.5 ms; energy 100–125 J/cm2); treatment interval was 3–4 weeks. All lesions disappeared after one or two treatments. There was no apparent scar formation, no impact on the function of the fingers and toes, no damage to nail growth, and no recurrence in more than 12-month follow-up. Nd-YAG is an effective and safety treatment option for treatment of PG located on the fingers and toes.

Keywords

Pyogenic granuloma Nd-YAG laser Fingers Toes 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Harris MN, Desai R, Chuang TY, Hood AF, Mirowski GW (2000) Lobular capillary hemangiomas: an epidemiologic report, with emphasis on cutaneous lesions. J Am Acad Dermatol 42(6):1012–1016CrossRefPubMedGoogle Scholar
  2. 2.
    Patrice SJ, Wiss K, Mulliken JB (1991) Pyogenic granuloma (lobular capillary hemangioma): a clinicopathologic study of 178 cases. Pediatr Dermatol 8(4):267–276CrossRefPubMedGoogle Scholar
  3. 3.
    Akamatsu T, Hanai U, Kobayashi M, Miyasaka M. Pyogenic granuloma: a retrospective 10-year analysis of 82 cases. Tokai J Exp Clin Med 2015; 20; 40(3):110–4Google Scholar
  4. 4.
    Pagliai KA, Cohen BA (2004) Pyogenic granuloma in children. Pediatr Dermatol 21(1):10–13CrossRefPubMedGoogle Scholar
  5. 5.
    Lee J, Sinno H, Tahiri Y, Gilardino MS (2011) Treatment options for cutaneous pyogenic granulomas: a review. J Plast Reconstr Aesthet Surg 64(9):1216–1220CrossRefPubMedGoogle Scholar
  6. 6.
    Fekrazad R, Nokhbatolfoghahaei H, Khoei F, Kalhori KA (2014) Pyogenic granuloma: surgical treatment with Er:YAG laser. J Lasers Med Sci 5(4):199–205PubMedPubMedCentralGoogle Scholar
  7. 7.
    Hasanoglu Erbasar GN, Senguven B, Gultekin SE, Cetiner S (2016) Management of a recurrent pyogenic granuloma of the hard palate with diode laser: a case report. J Lasers Med Sci 7(1):56–61CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Wollina U (2016) Three hundred patients treated with ultrapulsed 980 nm diode laser for skin disorders. Indian J Dermatol 61(5):540–544CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Gupta D, Singh N, Thappa DM (2016) Is timolol an effective treatment for pyogenic granuloma? Int J Dermatol 55(5):592–595CrossRefPubMedGoogle Scholar
  10. 10.
    Chiriac A, Birsan C, Podoleanu C, Moldovan C, Brzezinski P, Stolnicu S (2016) Noninvasive treatment of pyogenic granulomas in young children with topical timolol and trichloroacetic acid. J Pediatr 169:322–322CrossRefPubMedGoogle Scholar
  11. 11.
    Piraccini BM, Alessandrini A, Dika E, Starace M, Patrizi A, Neri I (2016) Topical propranolol 1% cream for pyogenic granulomas of the nail: open-label study in 10 patients. J Eur Acad Dermatol Venereol 30(5):901–902CrossRefPubMedGoogle Scholar
  12. 12.
    Liu J, Zhou BR, Yi F, Wu HJ, Zhang JA, Luo D (2016) Pyogenic granuloma in a patient with psoriasis successfully treated by 5 aminolevulinic acid photodynamic therapy: a case report. Exp Ther Med 11(1):345–347CrossRefPubMedGoogle Scholar
  13. 13.
    Malvehy J, Puig S, Argenziano G, Marghoob AA, Soyer HP, International Dermoscopy Society Board members (2007) Dermoscopy report: proposal for standardization. Results of a consensus meeting of the International Dermoscopy Society. J Am Acad Dermatol 57(1):84–95CrossRefPubMedGoogle Scholar
  14. 14.
    Zaballos P, Carulla M, Ozdemir F, Zalaudek I, Bañuls J, Llambrich A, Puig S, Argenziano G, Malvehy J (2010) Dermoscopy of pyogenic granuloma: a morphological study. Br J Dermatol 163(6):1229–1237CrossRefPubMedGoogle Scholar
  15. 15.
    Grazzini M, Stanganelli I, Rossari S, Gori A, Oranges T, Longo AS, Lotti T, Bencini PL, De Giorgi V (2012) Dermoscopy, confocal laser microscopy, and hi-tech evaluation of vascular skin lesions: diagnostic and therapeutic perspectives. Dermatol Ther 25(4):297–303CrossRefPubMedGoogle Scholar
  16. 16.
    Godfraind C, Calicchio ML, Kozakewich H (2013) Pyogenic granuloma, an impaired wound healing process, linked to vascular growth driven by FLT4 and the nitric oxide pathway. Mod Pathol 26(2):247–255CrossRefPubMedGoogle Scholar
  17. 17.
    Lin RL, Janniger CK (2004) Pyogenic granuloma. Cutis 74(4):229–233PubMedGoogle Scholar
  18. 18.
    Lim YH, Douglas SR, Ko CJ, Antaya RJ, Mcniff JM, Zhou J, Choate KA, Narayan D (2015) Somatic activating RAS mutations cause vascular tumors including pyogenic granuloma. J Invest Dermatol 135(6):1698–1700CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Groesser L, Peterhof E, Evert M, Landthaler M, Berneburg M, Hafner C (2016) BRAF and RAS mutations in sporadic and secondary pyogenic granuloma. J Invest Dermatol 136(2):481–486CrossRefPubMedGoogle Scholar
  20. 20.
    Marla V, Shrestha A, Goel K, Shrestha S (2016) The histopathological spectrum of pyogenic granuloma: a case series. Case Rep Dent 2016:1323798PubMedPubMedCentralGoogle Scholar
  21. 21.
    Goldberg DJ, Sciales CW (1991) Pyogenic granuloma in children: treatment with the flashlamp-pumped pulsed dye laser. J Dermatol Surg Oncol 17(12):960–962CrossRefPubMedGoogle Scholar
  22. 22.
    Glass AT, Milgraum S (1992) Flashlamp-pumped pulsed dye laser treatment for pyogenic granuloma. Cutis 49(5):351–353PubMedGoogle Scholar
  23. 23.
    González S, Vibhagool C, Falo LD Jr, Momtaz KT, Grevelink J, González E (1996) Treatment of pyogenic granulomas with the 585 nm pulsed dye laser. J Am Acad Dermatol 35(3 Pt 1):428–431CrossRefPubMedGoogle Scholar
  24. 24.
    Miller PK, Levitt J (2011) Treatment of multiple periungual pyogenic granulomata from pincer nails with pulsed dye laser. Dermatol Surg 37(8):1176–1179CrossRefPubMedGoogle Scholar
  25. 25.
    Sud AR, Tan ST (2010) Pyogenic granuloma-treatment by shave-excision and/or pulsed-dye laser. J Plast Reconstr Aesthet Surg 63(8):1364–1368CrossRefPubMedGoogle Scholar
  26. 26.
    Bourguignon R, Paquet P, Piérard-Franchimont C, Piérard GE (2006) Treatment of pyogenic granulomas with the Nd-YAG laser. J Dermatolog Treat 17(4):247–249CrossRefPubMedGoogle Scholar
  27. 27.
    Bédard MS, Boulanger J (2009) Treatment of lobular capillary hemangioma with the Nd:YAG laser: retrospective case series of 25 patients. J Cutan Med Surg 13(3):181–182CrossRefPubMedGoogle Scholar
  28. 28.
    Hammes S, Kaiser K, Pohl L, Metelmann HR, Enk A, Raulin C (2012) Pyogenic granuloma: treatment with the 1,064-nm long-pulsed neodymium-doped yttrium aluminum garnet laser in 20 patients. Dermatol Surg 38(6):918–923CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  • J. Dong
    • 1
  • S. G. Peng
    • 1
  • X. Y. Zhang
    • 1
  • C. G. Tong
    • 1
  • F. Liu
    • 1
  • M. Cao
    • 1
  • Y. H. Li
    • 1
  • Y. L. He
    • 1
  1. 1.Dermatology Department, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina

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