A 30-year-old female presented with 4 months history after a trauma, of an erythematous, soft crusted and painful nodule over the chin (Figure 1).

Dermoscopy was performed and revealed homogenous reddish area with white rail lines, an irregular linear vascularization at the basis, and white crusts with collarette at the upper (Figure 2).

Suggestive of pyogenic granuloma. Histopathology confirms the diagnosis revealing lobular capillary proliferation in upper dermis.

Pyogenic granuloma is dermoscopically characterized by reddish homogeneous area which is corresponded to the histologic finding of proliferating capillaries and veins [1]. The white lines like a double rail correspond to the histologic finding of fibrous septa that surround the lobules [2]. And finally, a white collarette corresponds to the hyperplastic adnexal epithelium that embraces the lesion at the periphery [1].

The identification of vascular structures in pyogenic granuloma is crucial because the presence of vascular structures in a red tumor resembling a pyogentic granuloma indicates that a melanoma should not be ruled out [3], such as in our case.

Conflict of Interest

The authors have no conflicts of interest to disclose.

References

1. Abhijeet KJ, Sonthalia S, Khopkar U. Dermoscopy of Pyogenic Granuloma. Indian Dermatol Online J. 2017; 8(6): 523-524.   
2. Kissou A, Hassam BE. Dermoscopy of pyogenic granuloma. Pan Afr Med J. 2017; 27: 110. doi: 10.11604/pamj.2017.27.110.12278   
3. Oiso N, Kawada A. Dermoscopy of pyogenic granuloma on the lip: the differing appearances of vascular structures with and without pressure. Eur J Dermatol. 2011; 21(3): 441. doi: 10.1684/ejd.2011.1338