Giant pyogenic granuloma complicating a folliculitis decalvans

Abstract

Pyogenic granuloma or lobular capillary hemangioma is a common and benign vascular proliferation that affects the skin and mucosa. It that can take many forms and be misleading in some cases. Its giant variant is very rare. The pathogenesis is unknown but multiple factors can play a role on its onset. It is considered to be a pseudotumoral reaction to various stimuli, such as trauma, hormonal changes or the use of some medications. We report the case of a 35 years old male patient who presented with a large, ulcerated tumefaction of the scalp evolving since 4 months. The physical examination revealed a crescent shaped large ulcerated tumor with signs folliculitis decalvans in the rest of the scalp. A skin biopsy was made and confirmed the diagnosis of pyogenic granuloma. The treatment consisted of a shave excision of the entire lesion. No recurrences were noted after two years of follow-up. This case illustrates the possible association of pyogenic granuloma with underlying dermatoses such as folliculitis decalvans.