Treatment of pyogenic granuloma with a 577-nm diode laser in dark-skinned patients: A prospective case series.

Abstract

Introduction: Pyogenic granulomas are common benign vascular lesions found on exposed skin in children. Treatment in darker skin types can be challenging because of increased epidermal melanin absorption and the associated risk of collateral thermal injury.

Objectives: To evaluate the efficacy and safety of a 577-nm diode laser for the treatment of pyogenic granuloma in patients with dark skin types.

Patients and methods: Nine patients with pyogenic granuloma and skin types IV-V were enrolled in this prospective case series. They were treated every two weeks with a 577 nm diode laser using a 1 mm spot size, with fluence ranging from 19-23 J/cm2 depending on lesion size until bleeding stopped. Sessions were repeated every two weeks until complete clearance. Patients were followed clinically and photographically every two weeks, and then one month after the final session.

Results: This prospective case series included 9 patients clinically diagnosed with pyogenic granuloma. The mean age was 18.0 ± 14.6 years (range, 6-40 years), and the mean duration of pyogenic granuloma was 9.1 ± 3.94 months. Lesions were present on the lips of 4 patients (44.4%), the cheeks in 2 patients (22.2%), hands (2 patients, 22.2%), and neck (1 patient, 11.1%). All patients were treated with a 577 nm diode laser session every 2 weeks until complete clearance. Complete clearance was achieved in 3 patients after the first session, 4 patients after the second session, 1 patient after third session, and only one patient required four treatment sessions. Atrophic scarring was the only reported side effect, occurring in one case.

Conclusion: Treatment with a 577-nm diode laser appears to be a safe and effective option for pyogenic granuloma in patients with darker skin types.