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Objective: This study aims to examine the expression of androgen receptor (AR) and estrogen receptor (ER) in patients with classic Kaposi's sarcoma (CKS) in Xinjiang, as well as to assess the serum levels of sex hormones in these patients. The objective is to explore potential new directions and targets for diagnosing and treating CKS in Xinjiang. Methods: The case group comprised 35 patients diagnosed with CKS who presented at our hospital from 2014 to 2021. The control group consisted of 35 patients with pyogenic granuloma (PG) who visited the hospital during the same period, selected using propensity score matching (PSM). Immunohistochemistry was used to detect AR, human herpesvirus type 8 (HHV‐8), and ER in paraffin‐embedded tissue samples from patients diagnosed with CKS and PG. Additionally, enzyme‐linked immunosorbent assay (ELISA) was used to quantitatively measure serum sex hormone levels in the 35 patients with CKS and 35 patients with PG. Results: AR expression was relatively weak in both the CKS and PG groups, with the PG group exhibiting a slightly stronger expression than the CKS group. Conversely, the expression of ER was significantly higher in the CKS group compared to the PG group (p < 0.05). Additionally, serum testosterone (T) levels were elevated in the CKS group, while serum estradiol (E2) levels were higher in the PG group (p < 0.05). Conclusion: Sex hormones and their receptors are implicated in the pathogenesis of CKS in Xinjiang. The use of ER antagonists may represent a novel avenue for research and treatment of CKS. [ABSTRACT FROM AUTHOR]

BACKGROUND: Toto bodies are homogeneous eosinophilic bodies, round to oval in shape with a peripheral clear appearance, also known as “Mucopolysaccharide keratin dystrophy” due to its contents, often seen on the topmost layers of stratified squamous epithelium of reactive and inflammatory oral lesions. The present study aimed to correlate the presence of epithelial Toto bodies with inflammatory components of the connective tissue in oral reactive lesions to elucidate the association between them. Material and Methods: This preliminary study included 12 archival reactive lesional slides (seven pyogenic granuloma [PG] and five inflammatory hyperplasia) with toto bodies and the correlation with inflammatory component of the connective tissue with regard to such as intensity, type of inflammatory cells was evaluated. RESULTS: Toto bodies were found in PG (58%), followed by inflammatory hyperplasia (42%). Almost 75% of cases exhibited diffuse distribution of chronic inflammatory cells, predominantly plasma cells (58%), followed by lymphocytes (42%) in the underlying connective tissue, followed by focal inflammatory cells that accounted for only 25% of cases. A positive correlation of toto bodies with connective tissue inflammation was noted. CONCLUSION: There was a positive correlation seen between the existence of epithelial toto bodies with the underlying connective tissue inflammation. The existence of toto bodies may aid as a diagnostic clue for the lesion being reactive/inflammatory in origin

Introduction: Pyogenic granuloma presents clinically as a rapidly growing, friable, red papule of skin or mucosa, commonly measuring less than 10 mm with frequent bleeding due to ulceration. Angioproliferative diseases including pyogenic granuloma and cherry angioma have been reported during COVID-19 infection or following COVID-19 vaccination. Case Presentation: Here, we report a 52-year-old female patient who developed diffuse skin eruptions 3 weeks after the second dose of COVID-19 vaccination. Conclusion: As per our knowledge, this is the first case of eruptive PG following COVID-19 vaccination. Oral propranolol and PDL laser therapy were administered after obtaining inconvenient results from electro-cautery, and there was a good response within 6 weeks of starting therapy, defined by the cessation of new lesion formation and a decrease in the size of large lesions.

The aim of this case report is to present a unique and rare finding in a 29-year-old male with the chief complaint of swelling in the gums related to the back teeth of the lower left jaw, since 20 days. In the absence of any alarming findings on the intraoral periapical radiograph and blood profile, an excisional biopsy of the provisionally diagnosed pyogenic granuloma was planned with a high-power diode LASER (Light Amplification by Stimulated Emission of Radiation). Following the excision, an unusual amount of bleeding was encountered from a single point on the buccal cortical plate between the teeth #35 and #36. On reevaluating the left face with advanced radiodiagnostic methods, an accessory buccal foramen was reported distal to #35 which housed a thin, tortuous, and aberrant branch of the inferior alveolar artery. The swelling was histopathologically diagnosed as lobular capillary hemangioma, and the aberrant artery was labeled as its feeder vessel. The patient had no episode of recurrence until 2 years of follow-up.

Rationale: Pyogenic granuloma (PG) is a commonly observed reactive soft-tissue lesion, often arising due to prolonged mild irritation or hormonal fluctuations in the oral cavity. Clinically, PG presents as a lesion with a smooth or lobulated appearance, which can be either sessile or pedunculated, and typically exhibits an hemorrhagic tendency. Very few cases of calcification in a PG have been reported in the past as these rarely exhibit ossification when viewed under a microscope. Patient Concerns: The following report is a case of a PG, that presented as a growth with occasional pain in the right upper back region of a 54 year old female. The patient reported no other concerns. Diagnosis: A provisional diagnosis of PG was given following thorough clinical and radiographic investigations. This was confirmed by a histopathological examination following an excisional biopsy. Intervention: The patient was treated with surgical excision as a part of the excisional biopsy of the lesion. Follow-up for the patient was done after 6 months, and there were no signs or indications of recurrence. Outcomes: The histopathological examination revealed regions of calcification, which are uncommon in PG, in addition to the characteristic hallmarks of proliferating endothelial cells, blood vessels, and inflammatory cells.

Pyogenic granuloma (PG) is a benign vascular neoformation, presenting as a painful red nodule on the skin, mucosa or nail apparatus. It is usually related to local complications such as bleedings and superinfections. The etiology of PG remains still unclear, and several triggers can lead to its formation. In case of multiple lesions, systemic conditions and drugs remain the main causes. Antineoplastic treatments, retinoids, antiretrovirals, hormones and anticonvulsants are frequently implicated in PG formation. In literature, PG has been rarely described in the course of biological treatment due to rheumatological disease. The present case report describes the development of polydactolous PGs in a 21-year-old woman with juvenile systemic lupus erythematosus (jSLE) during treatment with belimumab, a monoclonal antibody directed against BlyS. The clinical presentation, in particular the timing and the multiplicity of the lesions, and the improvement after belimumab discontinuation allowed us to consider PG as drug-induced. This case highlights the importance of considering PG as a potential complication of rheumatologic treatments. [ABSTRACT FROM AUTHOR]

Introduction: Pyogenic granuloma presents clinically as a rapidly growing, friable, red papule of skin or mucosa, commonly measuring less than 10 mm with frequent bleeding due to ulceration. Angioproliferative diseases including pyogenic granuloma and cherry angioma have been reported during COVID-19 infection or following COVID-19 vaccination. Case Presentation: Here, we report a 52-year-old female patient who developed diffuse skin eruptions 3 weeks after the second dose of COVID-19 vaccination. Conclusion: As per our knowledge, this is the first case of eruptive PG following COVID-19 vaccination. Oral propranolol and PDL laser therapy were administered after obtaining inconvenient results from electro-cautery, and there was a good response within 6 weeks of starting therapy, defined by the cessation of new lesion formation and a decrease in the size of large lesions. [ABSTRACT FROM AUTHOR]

Cutaneous pyogenic granulomas (PGs) are common, benign vascular tumors of uncertain pathogenesis; however, a growing body of literature suggests that the formation of PGs may be secondary to genetic alterations in both the Ras/Raf/MAPK and PI3K/Akt/mTOR pathways. We present three cases of spontaneous multifocal PGs that first presented in infancy, were not associated with other vascular anomalies or discernable etiology, harbored somatic genetic variants in the Ras/Raf/MAPK pathway (NRAS n = 2, FGFR1 n = 1), were refractory to treatment with beta‐blockers and mTOR inhibitors, and responded best to pulsed dye laser. We propose the term “spontaneous multifocal PGs” to describe this entity. [ABSTRACT FROM AUTHOR]

Background: Pyogenic granulomas (PGs) are gingival enlargements which cause esthetic and functional problems that hinder chewing and maintaining oral hygiene. In this series consisting of six cases, we report the rehabilitation of PG using partly de‐epithelialized gingival grafts. Methods: Following documentation of clinical measurements, a concurrent treatment plan of excision and reconstruction with partly de‐epithelialized gingival grafts were followed for all the cases. Six months following procedures, clinical parameters were measured again and a short patient‐reported outcome measures consisting of three questions were applied. Results: In histological evaluations, PG features were observed. In the fourth postoperative week, interdental papilla and attached gingiva were restored. Six months follow‐up showed reduction in plaque and gingival indices, clinical attachment loss, and mobility. Mean keratinized tissue height was increased from 2.58 ± 2.20 to 6.66 ± 1.66 in the 6th month of operation. Oldest case was stable after 12 months of follow‐up and no infection was found at grafting sites. Papillary coverage was achieved. Conclusion: If the PG is not completely removed due to esthetic reservations, a recurrence may occur. Within our limitations, we can suggest that the immediate esthetic rehabilitation with partly de‐epithelialized gingival graft presents a compatible approach in the treatment of mucogingival defects after aggressive excision of PG. [ABSTRACT FROM AUTHOR]

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Kindler syndrome (KS) is a rare autosomal recessive genodermatosis characterized by congenital acral blistering, that typically presents in infancy and is followed by the development of characteristic poikilodermatous pigmentation and photosensitivity in later life. These clinical manifestations arise from mutations in the FERMT-1 (Fermitin family homologue 1) that encodes kindlin-1, a protein localized to focal adhesions in keratinocytes. Kindlin-1 plays a crucial role in integrin receptor activation, which is essential for cell adhesion and migration. Most KS cases exhibit reduced or absent kindlin-1 expression, leading to defective integrin activation and impaired cell adhesion and migration processes. This impaired cell adhesion ultimately results in the blistering phenotype observed in KS. Oral manifestations of KS are frequently under-reported and misdiagnosed, potentially leading to delayed or incorrect treatment. Furthermore, diabetes mellitus (DM) can further exacerbate the severity of KS due to impaired epidermal barrier function and compromised periodontal health. This co-morbidity creates a synergistic effect. Periodontal infection, often exacerbated by DM through a caspase-3-dependent mechanism, can cause apoptosis of epithelial cells and fibroblasts. This enhanced apoptosis and loss of epithelial barrier function due to DM further hinder tissue repair processes. Consequently, both cutaneous and oral complications associated with KS become more severe in diabetic patients. We report a unique case of a diabetic adolescent with KS presenting with a massive oral pyogenic granuloma and extensive periodontal destruction with a comprehensive review of the literature exploring the current understanding of oral manifestations in KS, emphasizing their under-diagnosis and potential for exacerbation by DM. This case emphasizes the need for increased awareness of oral manifestations in KS, especially in diabetic patients. Early diagnosis and a multidisciplinary approach are crucial for optimal management of cutaneous and oral complications associated with KS.

Haemangiomas are benign proliferative tumours with vascular tissue origin. These neoplasms are recognised as benign tumours commonly found in infancy, characterised by a period of rapid growth accompanied by proliferation of endothelial cells, followed by gradual involution. The male to female ratio is observed to be 3:1, with a predominant impact on the female population, particularly during the early stages of their second decade of life. The diameter of the lesion spans from a few millimeters to several centimeters, with rare instances exceeding 2.5 cm. The present case report details the occurrence of Lobular Capillary Haemangioma (LCH) in a young male patient of six years, who exhibited gingival overgrowth in the anterior maxillary region. The patient presented with symptoms of discomfort during mastication, occlusal interference, and excessive hemorrhage during oral hygiene practices. Due to the lesion’s extensive blood supply and the confirmation of the diagnosis in the histology report, it was surgically removed in a single session while the patient was under conscious anaesthesia. The patient underwent a thorough six-month follow-up examination, which demonstrated a favourable outcome with no evidence of lesion recurrence. Although haemangiomas are prevalent soft tissue tumours in the head and neck region, they are infrequently found in the oral cavity and rarely encountered by doctors. Intraoral haemangiomas most commonly occur in the lips, tongue, buccal mucosa, and palate. However, this case report describes a rare occurrence in the maxillary anterior site, which has limited documentation. The treatment involved the use of monopolar cautery, which effectively reduced bleeding at the surgical site after the use of a scalpel. The purpose of present case report is to report an unusual case of a benign tumour occurring in the anterior maxillary region, which was diagnosed as LCH.

Purpose: We describe a case of metastatic conjunctival squamous cell carcinoma (SCC) presenting as an infectious sclerokeratouveitis in a patient with autoimmune disease. Observations: A 63-year-old Caucasian female presented to the cornea service with a raised perilimbal scleral infiltrate, hypopyon, and corneal perforation concerning for infectious necrotizing sclerokeratoveitis. She had an ocular history of a recurrent “pyogenic granuloma” and her medical history was notable for well-controlled systemic lupus erythematosus and rheumatoid arthritis. Scleral debridement and repair with a corneal patch graft was performed. Bacterial cultures grew 4+ Proteus mirabilis sensitive to tobramycin. One month later, she developed bulky painless scleral lesions with leukoplakic features. A scleral biopsy revealed squamous cell carcinoma. Imaging suggested ciliary body and medial rectus infiltration without perineural invasion. Right anterior exenteration was performed as immunotherapy was felt to be unlikely to achieve success in light of her autoimmune conditions. Six months later, she developed a palpable right parotid mass with biopsy confirming metastatic squamous cell carcinoma. She underwent a right parotidectomy and is now undergoing consolidative radiotherapy. Conclusions and Importance: Ocular surface neoplasia can present as a necrotizing sclerokeratouveitis, contributed by both the tumor and an atypical infectious process. Malignancy with superinfection should be in the differential diagnosis of recurrent ocular surface inflammation.

Haemangiomas are benign proliferative tumours with vascular tissue origin. These neoplasms are recognised as benign tumours commonly found in infancy, characterised by a period of rapid growth accompanied by proliferation of endothelial cells, followed by gradual involution. The male to female ratio is observed to be 3:1, with a predominant impact on the female population, particularly during the early stages of their second decade of life. The diameter of the lesion spans from a few millimeters to several centimeters, with rare instances exceeding 2.5 cm. The present case report details the occurrence of Lobular Capillary Haemangioma (LCH) in a young male patient of six years, who exhibited gingival overgrowth in the anterior maxillary region. The patient presented with symptoms of discomfort during mastication, occlusal interference, and excessive hemorrhage during oral hygiene practices. Due to the lesion's extensive blood supply and the confirmation of the diagnosis in the histology report, it was surgically removed in a single session while the patient was under conscious anaesthesia. The patient underwent a thorough six-month follow-up examination, which demonstrated a favourable outcome with no evidence of lesion recurrence. Although haemangiomas are prevalent soft tissue tumours in the head and neck region, they are infrequently found in the oral cavity and rarely encountered by doctors. Intraoral haemangiomas most commonly occur in the lips, tongue, buccal mucosa, and palate. However, this case report describes a rare occurrence in the maxillary anterior site, which has limited documentation. The treatment involved the use of monopolar cautery, which effectively reduced bleeding at the surgical site after the use of a scalpel. The purpose of present case report is to report an unusual case of a benign tumour occurring in the anterior maxillary region, which was diagnosed as LCH. [ABSTRACT FROM AUTHOR]

Aim: To discuss the diagnosis and treatment of an exuberant oral pyogenic granuloma (OPG) in the palatal region in a systemically compromised patient. Methods and Results: A 50‐year‐old woman presented with extensive and painless nodular mass that extended throughout the palatal region, with difficulty speaking, swallowing and spontaneous bleeding for 6 months. Her medical history showed poorly controlled type II diabetes mellitus and hypertension. The intraoral physical examination also revealed poor oral hygiene and periodontal disease. After clinical and radiographic evaluation, the presumptive diagnosis of OPG was made and complete excision of the lesion was performed. Local hemostatic measures were employed to control bleeding. Microscopic evaluation showed a lobulated lesion composed of many blood capillaries confirming the diagnostic hypothesis. Conclusions: In summary, individuals with severe periodontal disease and systemic disorders may present exacerbated clinical presentations of OPG. [ABSTRACT FROM AUTHOR]

Lobular capillary hemangioma is a benign lesion commonly affecting the head and neck region. However, in children, it is commonly seen in the buccal mucosa, gingiva, and the tongue, but its presence in the nasal cavity is less frequent. The most common symptoms of nasal hemangiomas are epistaxis and nasal obstruction. However, we present a case of a thirteen-year-old male having intranasal lobular capillary hemangioma with a 2-day history of left-sided epistaxis. The diagnosis is confirmed by histological examination, and the treatment is done by endonasal endoscopic excision of the hemangioma with cauterization of the feeding vessel has performed to remove the lesion completely. Moreover, the diagnosis of lobular capillary hemangioma must always be kept in mind when discussing the differential diagnosis of a bleeding mass within the nasal cavity, even though it is a rare condition and surgical excision is still the preferred first-line treatment. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate immunophenotypic profiles of infiltrating cells in surgically excised tissues of chalazion and pyogenic granuloma associated with chalazion. Methods: Eighty-two surgical specimens from 74 consecutive patients newly diagnosed with chalazion or chalazion-associated pyogenic granuloma at Tokyo Medical University Hospital between 2016 and 2022 were studied. Sixty specimens were chalazion lesions and 22 specimens were pyogenic granuloma lesions (from 15 men and 7 women, mean age 36.6 ± 14.4 years). All patients were immunocompetent Asian Japanese adults. Specimens were analyzed by immunohistochemistry and flow cytometry. Flow cytometry was performed using the following antibodies: CD3, CD4, CD8, CD11b, CD11c, CD16, CD19, CD20, CD23, CD25, CD34, CD44, CD56, CD69, and CD138. Results: In flow cytometric analysis, the proportion of cells expressing the T cell marker CD3 was significantly higher compared with other immune cells expressing specific markers (p < 0.0001), and the proportion of CD4-positive T cells was significantly higher than that of CD8-positive T cells (p < 0.0001), in both chalazion and pyogenic granuloma specimens. The chalazion and pyogenic granuloma lesions shared similar immunophenotypic profile characterized by predominant T cell infiltration, and CD4 T cells dominating over CD8 cells. The pattern of expression of CD4 and CD8 in the specimens was confirmed by immunohistochemistry. Conclusion: The present study demonstrates immunophenotypic features of chalazion and chalazion-associated pyogenic granuloma. Although various inflammatory cells are involved in the pathology of chalazion and pyogenic granuloma, a significantly higher proportion of CD4-positive T cells may be closely related to the pathological mechanisms of both lesions. [ABSTRACT FROM AUTHOR]

Background: A typical non-neoplastic connective tissue proliferations called a pyogenic granuloma. A vascular adhesion molecule used to assess angiogenesis is the CD34 marker. The primary memberof a family of growth factors, VEGF helps in generating and maintaining the lymphatic and blood circulation systems. Objective: The aim of the study was to know the correlation between VEGF and CD34 protein marker and pyogenic granuloma. Methods: Thirty-one formalin fixed paraffin embedded (FFPE) blocks were taken from female pyogenic granuloma patients ranging in age from 29 to 70. The IHC was used to identify VEGF and CD34 expression in the cytoplasm of the cells. Results: Seventeenout of 31 patients had VEGF positive expression. Twenty-sixout of 31 had CD34 positive expression and 5 with no expression (negative expression). Brown-stained cytoplasm showed high VEGF and CD34 expression, whereas blue stained cytoplasm showed no VEGF and CD34 expression in these cells. Conclusions: The results suggest the role of suchbiomarkers in the oral pyogenic granuloma pathogenesis, and it appears that CD34 and VEGF are valuable biomarkers in evaluating vascular and inflammatory diseases like pyogenic granuloma. [ABSTRACT FROM AUTHOR]

Rationale: Pyogenic granuloma (PG) is a commonly observed reactive soft-tissue lesion, often arising due to prolonged mild irritation or hormonal fluctuations in the oral cavity. Clinically, PG presents as a lesion with a smooth or lobulated appearance, which can be either sessile or pedunculated, and typically exhibits an hemorrhagic tendency. Very few cases of calcification in a PG have been reported in the past as these rarely exhibit ossification when viewed under a microscope. Patient Concerns: The following report is a case of a PG, that presented as a growth with occasional pain in the right upper back region of a 54 year old female. The patient reported no other concerns. Diagnosis: A provisional diagnosis of PG was given following thorough clinical and radiographic investigations. This was confirmed by a histopathological examination following an excisional biopsy. Intervention: The patient was treated with surgical excision as a part of the excisional biopsy of the lesion. Follow-up for the patient was done after 6 months, and there were no signs or indications of recurrence. Outcomes: The histopathological examination revealed regions of calcification, which are uncommon in PG, in addition to the characteristic hallmarks of proliferating endothelial cells, blood vessels, and inflammatory cells. [ABSTRACT FROM AUTHOR]

Caudal malocclusions in cats may result in a variety of traumatic lesions affecting the soft tissues of the ipsilateral mandible such as fovea, gingival cleft, and proliferative lesions. Fifty-one cats diagnosed with a traumatic caudal malocclusion were compared with a control hospital population and evaluated for prevalence with respect to breed and sex. Twenty-two cats that were treated had radiographic, clinical findings, and the outcome of treatment (extraction or odontoplasty) recorded. Maine Coon, Persian, and male neutered cats were overrepresented while Domestic Shorthairs were underrepresented within the study population. Radiographically, 50% of the fovea lesions had an area of decreased bone density in the region of the lesion and none of these had evidence of periodontal disease. All gingival cleft lesions had radiographic changes consistent with periodontal disease. 15.4% of proliferative lesions presented with radiographic changes, with only half of those presenting with both radiographic and clinical evidence of periodontal disease. Eleven cats were treated by odontoplasty and eleven by extraction. One cat treated by odontoplasty developed new lesions caudally, and another had persistence of the initial lesions. Two cats in the extraction group developed new lesions rostral to the extracted teeth. In most instances, odontoplasty or extraction resulted in successful soft tissue lesion resolution. In rare cases, additional treatment was necessary due to either persistence or development of new lesions. [ABSTRACT FROM AUTHOR]

Key Clinical Message Caruncle lesions are uncommon, though it may be involved by a wide variety of lesions including tumors and cysts of the conjunctiva, skin, or lacrimal gland. Lobular capillary haemangioma of the caruncle is a rare occurrence but may mimic some primary or secondary malignant neoplasms. Excision and histopathological examination confirm the diagnosis. Abstract The caruncle lesions are uncommon. Lobular capillary haemangioma involving caruncle is a rare occurrence. We present a case of large lobular capillary haemangioma of caruncle in a 10‐year‐old boy, was treated successfully by surgical excision.

Abstract The clinical appearances of Pyogenic granuloma (PG) in children are not as typical as in adults. Meanwhile, skin biopsy is hard to accept for parents in most of time. Therefore, data of PG in children has been deprived. To analyze the dermoscopic features of PG in children in order to improve the efficiency of diagnosis and treatment and to reduce the probability of invasive examination. A single‐center retrospective study conducted from 1 January 2022 to 30 August 2022 summarized and analyzed the clinical data and dermoscopic features of patients clinically diagnosed with PG. A total of 36 patients were involved, 61.11% were males, 72.22% occurred in the face. Over 50% patients had the following dermoscopic patterns: reddish homogeneous area (100%), white collarette (91.7%), yellow‐white scales (69.4%), vascular structures (52.8%), and white rail lines (55.6%). Regression analysis found that gender and courses of disease had a statistically significant impact on part of the dermoscopic patterns. The proportions of dermoscopic features with yellow‐white scales (69.4%), dark red scabs (27.8%), and bleeding (27.8%) in this study were higher than in previous studies (26.7%, 10%, and 10%, respectively). Dermoscope is a practical diagnostic tool for PG in children. It is necessary to consider gender, disease course and lesion locations when PG is diagnosed using dermoscope. The characteristics of yellow‐white scales, dark red scabs, and bleeding are the microscopic features that distinguish pediatric patients with PG from adult patients, which should be given special attention to in pediatric patients.

A 31-year-old man presented with gingival mass-like lesions. The patient reported occasional bleeding from lesions; otherwise, the lesions were asymptomatic. Intraoral examination revealed multiple interdental red/purple soft, sessile, nodular lesions involving both the maxillary and mandibular buccal and lingual gingivae, with poor oral hygiene. After performing incisional biopsy, the patient was diagnosed with pyogenic granuloma. Subsequently, the patient underwent cleaning of his teeth and within only 3 days of dental cleaning, the patient reported rapid regression of all his lesions. [ABSTRACT FROM AUTHOR]

Here, we report a case of a 70-year-old female who presented with a slowly enlarging tender nodule on the right forearm for several months. Physical examination showed a faintly blue-tinged freely mobile subcutaneous nodule. Excision was complicated by greater than expected bleeding and revealed an unexpected intravenous mass. Histopathology demonstrated capillary lobules separated by fibrous septae within a vein, consistent with intravenous lobular capillary hemangioma (IVLCH). IVLCH is a rare benign capillary proliferation of unclear etiology. Excision is typically curative and relieves any pain and discomfort the patient might be experiencing. With the addition of IVLCH, we respectfully propose a new acronym for the differential diagnosis of cutaneous tender tumors: intravenous lobular capillary hemangioma, foreign body (reaction), hidradenoma, osteoma cutis, glomus tumor, scar, fibromyxoma, leiomyosarcoma, eccrine angiomatous hamartoma, Dercum's disease (adiposis dolorosa), piezogenic pedal papule, eccrine spiradenoma, neurilemmoma (schwannoma), calcinosis cutis, angioendotheliomatosis, leiomyoma, metastases, angiolipoma, neuroma, dermatofibroma, granular cell tumor, endometriosis, thrombus, blue rubber bleb nevus, angioma, chondrodermatitis nodularis helicis, and keloid ("IF HOGS FLED PEN, CALM AND GET BACK"). Future additions to the cutaneous tender tumor differential diagnosis may require creative additions and rearrangements to this acronym. However, continual updates will allow it to serve both clinicians and pathologists alike as a comprehensive representation of etiologies to consider for cutaneous tender tumors.

Mucin-producing adenocarcinomas (MAC) are an extremely rare, indistinct group of neoplasm having either a salivary gland origin or with prominent glandular component. The diagnosis is chiefly based on the histological aspect conjoined with immunohistochemical evaluation as clinicoradiographical features are non-specific. It can arise as a primary metastasis to soft tissues, most commonly from either lung, breast, kidney, or colon. This paper reports a 51-year-old woman with buccolingual gingival swelling having a final diagnosis of metastatic mucinous adenocarcinoma from the breast. A tissue biopsy was performed followed by immunohistochemistry that confirmed the diagnosis. They are extremely rare, making the diagnosis challenging as it may mimic a benign neoplasm. It accounts for approximately 1% of all oral malignant neoplasms having gingival propensity. The clinician should therefore take into account every diagnostic aspect while encountering such oral lesions to achieve proper patient welfare. variant of salivary duct carcinoma making them exclusive and incoherent [3]. Mucinous adenocarcinoma is a rare malignant tumour composed of epithelial clusters within large pools of extracellular mucin that mostly occupy the lesion [4]. As mucinous differentiation was a nonspecific feature, in 2017 WHO grouped mucinous adenocarcinoma along with many entirely dissimilar tumors, into the broad category of adenocarcinoma not otherwise specified (NOS) [1,3]. This report presents a case of a 51-year-old woman with mucinous adenocarcinoma mimicking benign lesion along with its various clinical, histopathological, and diagnostic aspects. [ABSTRACT FROM AUTHOR]

Aim: Pyogenic granuloma (PG), also known as lobular capillary hemangioma, is a benign, reactive vascular tumor. We aimed to evaluate the demographic and clinical characteristics, treatments received, and outcomes of patients followed up at our clinic with PG. Materials and Methods: We retrospectively evaluated all patients followed up at our clinic with PG in the last 4 years. Results: A total of 144 patients were included in our study. 73 (51%) of the patients were female and 71 (49%) were male. The mean age of the patients was 31.3±8.3 years. When we examined the PG locations in our patients, we observed that it was most commonly found in the arm/hand area (40%), on the face (29%), foot/leg area (19%), and on the trunk (8.3%). The highest numbers of lesions were respectively in the hand, foot nail edge, and lip locations. Out of the patients where the lesion side was specified, 63 had the lesion on the left while 20 had it on the right (p=0.001). 51% of our patients underwent excisional surgery. Other treatments applied to our patients, in order, were cryotherapy (15.3%), electrocauterization (8.3%), and cauterization with silver nitrate, cryotherapy + electrocauterization, topical antibiotic and cryotherapy + timolol drop. When evaluating the outcomes of the patients, we learned from the notes dropped into the system at later controls that 73% had recovered. The remaining patients were lost to follow-up. When comparing the features of patients who were treated with non-excisional methods to those who underwent excision, we observed that there was a higher rate of patients younger than 12 years (p=0.023), a higher incidence of foot nail edge (p=0.016) and lip location (p=0.048), and a higher frequency of pregnancy in this group. Conclusion: PG is a vascular tumor of importance due to its potential for bleeding and ulceration and its chronic course if left untreated. Since there are malignant lesions in its differential diagnosis, we believe that surgical excision is a more appropriate treatment option in our clinical practice when feasible. We think that the data we have obtained needs to be supported by more comprehensive, broader, and prospective studies. [ABSTRACT FROM AUTHOR]

Melanoma is one of the rarest tumors in children. Its diagnosis is generally late, due to its misleading morphology and low level of suspicion. The diagnosis of pediatric melanoma remains extremely challenging due to the existence of neoformations that present clinical and histological overlaps and therefore requires great experience of the dermatologist and pathologist. We present the case of a rare pediatric melanoma, occurred on healthy skin with a pyogenic granuloma-like appearance in a 3-year-old girl, which benefited from multidisciplinary management. [ABSTRACT FROM AUTHOR]

Pyogenic granuloma is a benign proliferative fibrovascular lesion commonly arising from the skin and mucous membranes of the head and neck region. Histologically, this tumor is characterized by vascular proliferation and a circumscribed group of capillaries organized in lobules. It is usually located in the oral cavity and nasal location is less frequent. When it occurs in pregnant women, it is usually referred as pyogenic granuloma gravidarum. In this article we present the case of a pyogenic granuloma gravidarum in a young woman with intermittent epistaxis during the last trimester of pregnancy that did not resolve after childbirth and was treated with transnasal endoscopic resection and cautery at the base of the lesion for hemostasis under local anesthesia. [ABSTRACT FROM AUTHOR]

Hobnail hemangioma is a vascular tumor that typically occurs in young or middle-aged individuals. It usually affects the limbs or trunk but rarely the head and neck region. Hobnail hemangioma is classified as a benign vascular tumor. However, some authors emphasize that hobnail hemangioma is not a vascular tumor but a lymphatic malformation. Here, we report an unusual case of a hobnail hemangioma on the tongue with pyogenic granuloma-like appearances. A 50-year-old woman visited our department with a chief complaint of bleeding and pain on the right lateral side of her tongue. On intraoral examination, an irregular swelling of approximately 28 × 15 mm in size with a 10 × 10 mm ulcer with a well-defined border in the center was seen on the right lateral side of the tongue. Histopathologically, the subepithelial lesion demonstrated numerous neutrophilic infiltrates and capillary proliferation resembling a pyogenic granuloma. The deeper lesion showed abnormal dilated and slit-like vessels with a hobnail appearance intervening between collagen and vascular bundles, accompanied by minute hemosiderin deposition. All abnormal vessels were D2-40 positive, but WT1 was negative, which could indicate the nature of the hobnail hemangioma with inflammation. The patient shows no evidence of recurrence 2 years after surgery. Hobnail hemangioma is extremely rare but should be considered a differential diagnosis of oral vascular lesions. [ABSTRACT FROM AUTHOR]

The aim of this case report is to present a unique and rare finding in a 29‑year‑old male with the chief complaint of swelling in the gums related to the back teeth of the lower left jaw, since 20 days. In the absence of any alarming findings on the intraoral periapical radiograph and blood profile, an excisional biopsy of the provisionally diagnosed pyogenic granuloma was planned with a high‑power diode LASER (Light Amplification by Stimulated Emission of Radiation). Following the excision, an unusual amount of bleeding was encountered from a single point on the buccal cortical plate between the teeth #35 and #36. On reevaluating the left face with advanced radiodiagnostic methods, an accessory buccal foramen was reported distal to #35 which housed a thin, tortuous, and aberrant branch of the inferior alveolar artery. The swelling was histopathologically diagnosed as lobular capillary hemangioma, and the aberrant artery was labeled as its feeder vessel. The patient had no episode of recurrence until 2 years of follow‑up. [ABSTRACT FROM AUTHOR]

Reactive hyperplasia of connective tissue caused by local irritants is known as pyogenic granuloma. It is a tumor-like development of the oral cavity that is thought to be neoplastic in nature. It is typically found around the skin or anterior teeth. Numerous stressors, such as intense injury, low-grade local discomfort, hormone fluctuations, or certain drugs, are commonly the cause of it. Histologically, the surface epithelium may show foci of ulcerations, hyperkeratosis, or even intact. It sits on top of a thick mass of connective tissue with a high concentration of fully grown collagen. The most often impacted area is the gingiva, which is followed by the lips, tongue, and buccal mucosa. In general, pyogenic granuloma does not develop when the base and its contributing variables are removed. [ABSTRACT FROM AUTHOR]

Pyogenic granuloma (PG) is a benign vascular lesion found predominantly in the oral cavity. Characterized by rapid growth and propensity to bleed, PG presents diagnostic challenges due to its similarity and alarming proliferation. This narrative review synthesizes current knowledge on the epidemiology, etiopathogenesis, clinical manifestations, and management of oral PG, with emphasis on recent advances in diagnostic and therapeutic approaches. The epidemiology of the injury is meticulously analyzed, revealing a higher incidence in women and a wide range of ages of onset. It delves into the etiopathogenesis, highlighting the uncertainty surrounding the exact causal factors, although historical attributions suggest an infectious origin. It exhaustively analyzes the clinical and histopathological aspects of oral PG, offering information on its various presentations and the importance of an accurate diagnosis to guide effective treatment. It details treatment strategies, emphasizing the personalized approach based on individual patient characteristics. This comprehensive review consolidates current knowledge on oral PG, highlighting the need for further research to clarify its pathogenesis and optimize treatment protocols. [ABSTRACT FROM AUTHOR]

Hair-thread tourniquet syndrome (HTTS) is an emergency phenomenon in which hair or thread tightly wraps around a protruding appendage of the body, resulting in pain, swelling, and rarely ischemia and amputation. While the toes, fingers, and external genitalia are the most affected areas, it can also impact other protruding parts of the body. Nevertheless, except for a few cases of skin tags and hemangioma, HTTS associated with a protruding skin mass is extremely rare in the literature. In this study, we present the management of two cases: One involving a pediatric patient with HTTS affecting the right fourth toe and the other involving a protruding pyogenic granuloma on the back of an adult patient.

Pyogenic granuloma is an inflammatory non-neoplastic lesion of the oral cavity. Chronic, mild, local irritation, trauma, hormonal variables, and certain medications are typical causes of pyogenic granulomas. Women have a higher prevalence than men. The risk is greatest in the second to fifth decades of life. Clinically, the lesion appears smooth, with soft to firm consistency and nontender with a pedunculated or sessile base. Various modalities have been proposed for the treatment of lesion, which include the conventional approach, the use of laser, cryotherapy, and electrocauterization. This case series discusses three cases of pyogenic granuloma in female patients at different locations in the oral cavity. The lesion was subsequently treated with electrosurgery and surgical convention methods. No recurrence of the lesion has been seen in either of the cases.

Background: Pyogenic granuloma is a benign and non-neoplastic mucocutaneous lesion that has multiple causes and develops in response to local irritation, trauma, or hormonal changes during pregnancy. In the oral cavity, this lesion often involves the anterior of the maxillary gingiva, and rarely, the tongue, labial mucosa, and palatal mucosa are involved. The clinical appearance of the lesion was usually seen as a nodule with or without a base, with a smooth surface or lobulated surface. It is usually non-tender, but it can bleed on touch. This lesion may be seen in any size from a few millimeters up to several centimeters. It is more common in females. This case report presents a rare site of a pyogenic granuloma on the dorsal site of the tongue. Clinical symptoms, causes, differential diagnosis, histology of the pyogenic granuloma, and treatment were discussed in this case report.

Primary amyloidosis of the conjunctiva and eyelid is a rare and often misdiagnosed condition. It is characterized by the deposition of insoluble amyloid fibrils, which are misfolded proteins, in the body. Amyloidosis can be systemic or localized with different types of amyloid fibril proteins identified using mass spectrometry. Ocular involvement in amyloidosis can lead to corneal dystrophies, glaucoma, vitreous opacities, and other symptoms. Diagnosis involves clinical examination and histopathological assessment. Treatment options depend on the extent of involvement and may include surgical excision, glaucoma management, vitrectomy, or liver transplantation in rare cases. We present a rare case of localized conjunctival amyloidosis initially misdiagnosed as pyogenic granuloma, with clinical symptoms of ptosis, periorbital swelling, and conjunctival lesions. The patient underwent excision of the lesions, and subsequent evaluation did not reveal systemic amyloidosis. Ocular amyloidosis requires careful diagnosis and consideration of systemic involvement for appropriate management. [ABSTRACT FROM AUTHOR]

Hair-thread tourniquet syndrome (HTTS) is an emergency phenomenon in which hair or thread tightly wraps around a protruding appendage of the body, resulting in pain, swelling, and rarely ischemia and amputation. While the toes, fingers, and external genitalia are the most affected areas, it can also impact other protruding parts of the body. Nevertheless, except for a few cases of skin tags and hemangioma, HTTS associated with a protruding skin mass is extremely rare in the literature. In this study, we present the management of two cases: One involving a pediatric patient with HTTS affecting the right fourth toe and the other involving a protruding pyogenic granuloma on the back of an adult patient. [ABSTRACT FROM AUTHOR]

Introduction:Lobular capillary hemangioma (LCH) is a vascular neoplasia with a pathogenesis that has not been fully clarified. The Wnt signaling pathway plays an essential role in vasculogenesis and angiogenesis. The increased activity in the Wnt signaling pathway may cause some neoplastic proliferations. This study revealed the role of the Wnt1/β-catenin signaling pathway in the development of LCH.Methods:The study included 30 LCH tissue samples. Vascular structures in healthy tissue surrounding LCH lesions were used as controls. Wnt1 and β-catenin protein expressions in tumor tissue and surrounding tissue vascular structures were evaluated using the immunohistochemical method.Results:Wnt1 expression was 1.10±0.16 and 0.33±0.10 in the LCH and control groups, respectively, indicating a statistically significant difference (p0.05).Conclusion:In LCH, the Wnt1/β-catenin signaling pathway expression is increased. This increase may be due to the increased Wnt1 gene expression, pathologies in different signaling pathways, or paracrine factors secreted from the tumor microenvironment. Treatment modalities targeting the Wnt1 signaling pathway may be promising for treating LCH.

Objectives Lobular capillary hemangioma (LCH) rarely involves the gastrointestinal (GI) tract. This study describes clinicopathologic features of LCH in a cohort of GI cases. Methods We defined lobular capillary hemangioma as "a proliferation of capillary-sized blood vessels arranged at least focally in a lobular configuration," searched departmental archives for cases, and recorded clinicopathologic findings. Results We identified 34 GI tract LCHs from 16 men and 10 women; 4 patients had multiple lesions. Mean age was 64 years. Cases arose in the esophagus (n = 7), stomach (n = 3), small bowel (n = 7), and colorectum (n = 17). Twelve patients had anemia or rectal bleeding. No patients had a known genetic syndrome. The lesions manifested as mucosal polyps, with median size of 1.3 cm. Microscopically, 20 lesions were ulcerated, and most involved the mucosa, with 9 extending into the submucosa. Vessel dilation was present in 27 patients, endothelial hobnailing in 13, hemorrhage in 13, and focal reactive stromal atypia in 2. Follow-up information was available for 10 patients, none of whom developed same-site recurrence. Six of the 26 cases (23%) were extradepartmental consultations, including 2 of the multifocal cases. Conclusions Gastrointestinal tract LCHs often arise as colorectal polyps. They are typically small but can reach a few centimeters in size and can be multifocal. [ABSTRACT FROM AUTHOR]