No evidence for either curettage or silver nitrate for pyogenic granulomas on the hand

Report By: Wendy Dollery - Specialist Registrar
Search checked by Vince Choudrey - Clinical Fellow
Institution: Manchester Royal Infirmary
Current web editor: Minnie Alexander - Senior Information Officer
Date Submitted: 1st March 2000
Date Completed: 30th June 2000
Last Modified: 11th April 2001
Status: Green (complete)

Three Part Question

In [an adult with a pyogenic granuloma on the hand] is [curettage better than cautery with silver nitrate] at [removing the lesion and preventing recurrence].

Clinical Scenario

A 23 year old woman attends the emergency department with a strange growth on the end of her finger. She cut herself on glass some 6 weeks previously. Examination reveals a lesion with the appearance of a pyogenic granuloma. You wonder whether you should remove the lump surgically or chemically.

Search Strategy

Medline 1966-12/98 using the OVID interface.
[exp granuloma OR granuloma$.mp OR granuloma, pyogenic OR granuloma, pyogenic.mp OR exp hemangioma, capillary OR capillary hemangioma$.mp] AND [exp hand OR exp thumb OR exp fingers OR hand$.mp OR thumb.mp OR finger$.mp OR digit$.mp]

Search Outcome

45 papers found none of which were relevant.

Comment(s)

There is no literature on the simple management of pyogenic granulomas of the hand. A multicentre trial of therapies for this condition is warranted.

Clinical Bottom Line

There is no evidence to determine whether curettage or cautery with silver nitrate is a better treatment for simple pyogenic granuloma of the hand. Local advice should be followed.