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11.12 Pyogenic Granuloma (Proud Flesh)


Presentation

Often there is a history of a laceration several days to a few weeks before presentation in the ED. The wound has not healed and now bleeds with every slight trauma. Objective findings usually include a crusted, sometimes purulent collection of friable granulation tissue arising from a moist, Some times hemorrhagic wound. There are usually no signs of a deep tissue infection.

What to do:

What not to do:

Discussion

It is not uncommon for a secondary cellulitis to develop after cauterizing the granuloma. It is therefore reasonable to place a patient on a short course (3-4 days) of a high dose antibiotic (dicloxicillin or cephalexin 500mg tid or cefadroxil lgm qd) when the wound is located on a distal extremity.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
Mark Smith, MD
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