#Pyogenic Granuloma Removal

[alrustomlaser]

Microdermabrasion By Crystal | Dr. Kamil Al Rustom Skin & Laser Centre

Microdermabrasion: this relatively painless, non-surgical technique may be used to freshen and rejuvenate the skin by using of a minimally abrasive instrument to gently sand the skin, exfoliating the thicker, uneven outer layer and relive a fresh younger looking skin with a healthy glow.

Know more about Microdermabrasion By Crystal

[perksofbeingawaifu]

What happened with your tongue during pregnancy??? That sounds awful, im so sorry

ahahahha oh man. i had something on my tongue called an oral pyogenic granuloma, also called a pregnancy tumor. it did not go away after pregnancy so i had to go to an oral surgeon to have it and the surrounding tissue removed. it hurt like a bitch, but it is all healed now. he said the tongue would grow back. it kinda looks like i'm missing a tic tac size chunk now.

anywho, codify roe.

[agingdisgracefully]

Day 1 Post-Total Nail Aversion (3-23-2024)

WE GOT THROUGH THE FIRST DRESSING CHANGE, LADS

((GRAPHIC DESCRIPTIONS BEYOND THE 'READ MORE'; YOU'VE BEEN WARNED))

After spending my first hour if consciousness in a state of panic, I set up shop in the bathroom, gathered my supplies and got to work - though I did take a brief interlude to text my brother and see what he thought re: soaking the nail (he's had a few partial nail avulsions and has a medical background)

The tape and gauze wrap came off with no problem, though I did have a mini-breakdown when I finally peeled enough gauze away to see some blood. There was what can best be described as a hunk of folded up gauze covering the wound that was caked in dried blood.

It very much reminded me of the gauze pads that a dentist would have you bite down on after getting a tooth pulled.

Cue panic. Cue tears. Cue overdramatic bullshit.

I filled my basin with enough lukewarm/room temp water to cover my foot, added a tablespoon of epsom salt, said a prayer, and put my foot in, making sure to swish my foot around every couple minutes.

The majority of the gauze loosened right off and left just a singular layer that I was pretty sure I was going to have to yank off - I think the fuck not. Decided to dump out and refill the basin just like the first time, soaking and swishing my foot for another 10 minutes. It still kind of wanted to stick in one corner, but it came pretty right off with no pain.

For a third (and final) time that day, I refilled the basin with water and now 1.5 tablespoons of epsom salt to do a 15 minute soak, as instructed by the podiatrist. There was some tingling, but like I told my mom "It's not really pain. It feels like my brain can't decide if it stings a bit or itches".

After 15 minutes, I took my foot out of the water - dried the other toes and rest of the foot with a regular towel, tried to dab a bit of the water off of the wound with a piece of regular gauze (not the non-stick) but it was too tender and I was too scared to push beyond a featherlight touch. There was a couple of tiny blood spots on the gauze I dabbed it dry with, but I saw no fresh bleeds so it must have soaked up the blood from the Proud Flesh (pyogenic granuloma) that my demon toe spawned; It doesn't look like the podiatrist removed it, but maybe it will go away on its own now that the source of irritation is gone. Slathered some triple antibiotic ointment (the kind with pain relief) onto the non-stick gauze with a q-tip, made sure it was enough to cover the full nail bed, and wrapped it back up.

Is my wrapping job as good as the podiatrist? No - but it'll do for now.

Gotta do that all over again, once per day for the next 14 days (though honestly I'll probably continue until my follow-up appointment in 2.5 weeks). Hopefully, all of the future dressing changes go as smoothly as this one.

[myspcae]

Addressing Common Skin Issues with Effective Solutions

In today's modern world, the preservation of skin health and aesthetics holds paramount importance. If you find yourself dealing with any of the following prevalent skin concerns, rest assured that effective solutions are within your reach. Seeking expert guidance from Elation Hair and Skin Clinic, recognized as the foremost hair and skin clinic in Kolkata, is a prudent choice.

Acne and Acne Scars:

Acne, a widespread skin condition, occurs when hair follicles become obstructed by a combination of oil, dead skin cells, and bacteria, resulting in the formation of unsightly pimples, blackheads, and whiteheads. This condition not only impacts the visual appeal of your skin but may also leave lasting scars.

Treatment: For mild to moderate acne, dermatologists often recommend the use of topical creams or gels containing active ingredients like benzoyl peroxide, salicylic acid, or retinoids. These formulations work to unclog pores, reduce inflammation, and prevent future breakouts.

For severe acne and the management of acne scars: Various treatment options are available, including oral medications for severe acne, such as antibiotics like tetracycline or macrolides (erythromycin, azithromycin) to combat the underlying bacterial and inflammatory factors. Isotretinoin, an oral retinoid, is often prescribed for severe acne to effectively reduce oil production and eliminate bacteria within the skin. The use of oral acne medications requires medical supervision due to potential side effects. Dermatological procedures for treating acne scars encompass chemical peels, microdermabrasion, and laser therapy. Additional options include dermal fillers, minor skin surgery, and subcision. The choice of the most suitable approach for treating acne scars is highly individual and necessitates the expertise of a dermatologist.

Moles and Warts:

Dermatologists meticulously assess and address moles and warts based on their distinct characteristics, offering tailored treatment options.

Moles: The majority of moles are benign and often require no intervention. However, moles showing changes or indicating potential malignancy may necessitate removal, which can be achieved through methods such as cryotherapy, laser therapy, or surgical excision. Regular monitoring of moles is essential for the early detection of skin cancer, particularly malignant melanoma.

Warts: These skin growths, attributable to the human papillomavirus (HPV), can be effectively treated through diverse methods, including cryotherapy, laser therapy, surgical removal, or the application of topical medications designed to eliminate or suppress the causative virus.

Other Benign Skin Growths:

A variety of benign skin growths, including dermatofibromas, dermoid cysts, freckles, keloids, keratoacanthomas, lipomas, and pyogenic granulomas, are typically non-threatening. Seeking guidance from a dermatologist is essential when addressing moles and warts, as it enables the determination of suitable treatments tailored to individual circumstances and skin type. For these and other common skin issues, a visit to the renowned hair and skin clinic in Kolkata may be the most prudent course of action.

Hyperpigmentation Treatment:

To rectify concerns associated with uneven skin tone and the presence of dark spots, it is recommended to employ topical products containing active ingredients such as hydroquinone, vitamin C, arbutin, or licorice extract. These components effectively inhibit melanin production, thereby promoting a more balanced and uniform skin tone.

Remedy: Achieving effective outcomes in hyperpigmentation treatment necessitates consistent and dedicated application of these products. For personalized guidance customized to your specific skin type and concerns, consulting a dermatologist is advisable.

In Conclusion:

For precise diagnosis and the application of suitable treatments, the expertise of a dermatologist is indispensable. Their professional counsel is pivotal in the effective management of these common skin concerns, ultimately restoring the vitality and allure of your skin. We strongly recommend considering treatment at Elation Hair and Skin Clinic, renowned as Kolkata's premier hair and skin clinic, for the attainment of optimal and enduring skincare results.

[lupine-publishers-ipdoaj]

980 nm Diode Laser: A Good Choice for the Treatment of Pyogenic Granuloma

Abstract

Pyogenic granuloma is a benign non/neo plastic mococutanous lesion . It is a reactional response to constant minor trauma and can be related to hormonal changes. Several methods can be applied to remove PG like surgery electrocauterisation and laser treatment. We report our experience for the treatment of two cases with pyogenic granuloma with diode laser 980 nm. Patients reported no pain or swelling after the treatment. The wounds were completely healed without scarring, providing good aesthetic results. Diode laser 980 nm is a good modality for the management of pyogenic granuloma.

Read More About This Article Please Click on Below Link: https://lupinepublishers.com/pediatric-dentistry-journal/fulltext/980-nm-diode-laser-a-good-choice-for-the-treatment-of-pyogenic-granuloma.ID.000265.php

Read More About Lupine Publishers Google Scholar Articles: https://scholar.google.com/citations?view_op=view_citation&hl=en&user=h1QvhsYAAAAJ&cstart=20&pagesize=80&citation_for_view=h1QvhsYAAAAJ:dfsIfKJdRG4C

[teamironmanforever]

So, 2020 wanted to be real on brand this December

I have had a nose bleed for a month and something was growing in my nose, found out it’s a pyogenic granuloma and I need to have surgery to have it removed. It’s painful and I can’t breathe so gotta breathe through my nose which means I can’t sleep and b/c of Covid scheduling said surgery is a damn struggle.

Meanwhile I also have a shitload of deadlines. 

[lady--katie]

😡😡 i hate my fucking feet 😡😡

i have been doing EVERYTHING my doctor has told me to do for my toe, after getting the ingrown portion of my toenail removed, and it seems like nothing is working. 

i wash it with warm soapy water, i soak my feet in epsom salts all the fucking time, i keep it covered with bacitracin and a band-aid, i’ve haven’t worn closed toed shoes or sneakers in like a month, i haven’t been able to workout in like a month, and YET, this toe is still bothering me!!

i’m wondering if i’m allergic to the bacitracin or the band-aids and it’s slowing the healing process down and irritating my toe or if it’s something else? i have no fucking idea, but it’s driving me nuts...

ugh, i’m sorry i keep complaining about my toes. i’m just annoyed af. 

in october/november/december it was the pyogenic granuloma and the removal of that on the right big toe. 

in february/march it was the ingrown toenail on my left big toe and the removal of that. and now it won’t heal. 

two weeks ago, i stubbed my right toe, and the nail embedded itself into the skin and caused a little granuloma to pop up again and i had to get that fixed last week. 

now the doctor wants a chemical matrixectomy (i think that’s what it’s called) done on both my toenails on the 16th and it sucks... i hope it will help, but it takes a while to heal.

 i feel like i’m being sent back to square one. 

[thecampbellfam]

My BF had a pyogenic granuloma and ended up having it removed because he kept bumping it into everything. Those things are surprising.

Interesting! It’s shocking how severe a bleed can be caused by bumping them or scratching them. I hope your BF’s surgery went well! I’m not looking forward to the possible surgery but I’m hopeful it’ll go well so that we don’t have any more ER visits.

[pioonlaser]

Soft tissue Laser Applications in Pediatrics

There are many applications for pediatric soft tissue laser procedures in oral surgery, oral pathology, periodontology and orthodontics — including frenectomies, frenotomies, operculectomies, gingivectomies, and treatment of aphthous and herpetic lesions.

Ankyloglossia of the infant is a common and well-studied condition in which the attachment of the lingual frenum is at the tip of the tongue. This is most common in boys, with a reported incidence of 4% to 5%. Ankyloglossia and restriction of tongue movement can result in poor breastfeeding and maternal nipple pain. Research shows that frenotomy can reduce maternal nipple pain, although the effect on breastfeeding quality has not been consistently proven. Frenotomy involves administering local anesthesia and using two instruments — such as a mosquito or hemostat — in a V shape to protect structures in the sublingual area, including the lingual nerve and Wharton’s duct. A scalpel, laser or electrosurgical knife is used to make a V-shaped incision separating the attachment. Advantages of using a laser include the specific interaction of the laser with treated tissue, rapid hemostasis, reduced postoperative discomfort and fast wound healing. The laser also has a decontaminating and antibacterial effect.

Laser labial frenectomy is completed in a similar fashion, but can also include surgical repositioning of the frenum attachment. While indications for labial frenectomy are varied, this procedure can improve access and cleansability of the facial surfaces of the young child’s incisors, reduce traction on the marginal gingiva, aid in orthodontic treatment of a persistent midline diastema, and modify labial or lingual anatomic issues in a multidisciplinary approach to speech development. Advantages of using a laser in frenectomy or frenotomy include reduced operating time, decreased use of local anesthetic and faster healing.

Removal of benign, diseased oral soft tissue, such as mucocele, gingival fibroma, and pyogenic granuloma, can also be achieved with a diode or Nd:YAG laser. Case reports also indicate successful use of Er-Cr:YSGG lasers for these procedures. Aphthous ulcers and herpetic ulcers may be treated with laser therapy, resulting in reduced healing time — although more high-quality studies are needed to determine effectiveness and treatment protocols.

Periodontal disease is found in a smaller percentage of pediatric patients than adults; nonetheless, teenagers and children present with various periodontal conditions. Some of the most common laser procedures performed in a pediatric population include gingivectomy, removal of operculum, or exposure of a submerged tooth for placement of an orthodontic bracket. Although laser decontamination of periodontal pockets in adults has been studied with varying results, there is little research in pediatric populations. At this time, laser therapy is best considered as an adjunct to traditional periodontal treatment.

Additionally, evolving fields in medicine and dentistry involve photobiomodulation (PBM) and low-level laser therapy (LLLT). In PBM, lasers are used to initiate a photochemical effect on a cellular level, without thermal or ablative characteristics. The majority of studies use diode lasers and attribute positive clinical changes to stimulation of mitochondrial cytochromes, eliciting increased cellular metabolism and improved cell viability. While more studies are needed, there is sufficient literature to support PBM in the treatment of oral mucositis — which is of interest to clinicians who manage patients undergoing radiation or chemotherapy.

[nrkss]

The Surprising Link Between Oral Health and Pregnancy

Pregnancy brings a high amount of physical and mental change, we all know during this time body produces excess levels of progesterone and estrogen hormones. These hormones can be blamed for loosening the bones and tissue that keep your teeth in order. In addition to oral health, pregnancy can also make a woman more sensitive to grow cavities and periodontal disease. Therefore, you need to be extra delicate to your oral health, essential for both you and the little one growing inside the womb. To book an appointment with the best gynecologist in Siliguri, contact New Ramkrishna Seve Sadan, the leading fertility hospital in North Bengal.

How pregnancy influences oral health

Pregnancy and cavities: Hormonal imbalance with unusual eating habits during pregnancy naturally puts you at risk for developing gum disease and bacterial formation. More craving for snacks, sugary food, and drinks in this phase is normal but alarming for oral health. The feeling of reluctance for brushing on time, skipping flossing practice these tiny negligences affecting your oral hygiene.

Pregnancy and gingivitis: High levels of pregnancy hormones increase the chance of catching gingivitis, it’s gum inflammation. Symptoms include swelling, redness, gum sensitivity, tooth bleeding.

Pregnancy and periodontal disease: if gingivitis remains undetected it can cause periodontitis, is a type of serious gum disease. It basically weakens tooth bones and tissues, also responsible for bacteremia that denotes bacteria in the bloodstream.

Pregnancy and tooth erosion: Puking during pregnancy is a normal condition, but directly affects tooth enamel, because of the stomach acid. This situation stays for the first few months of pregnancy.

Pregnancy tumors: Also, referred to as pyogenic granuloma, the lumps on and around the gum area, are not cancerous tumors. The plaque formation inside the mouth eventually leads to lumps development, which looks reddish, and bleeds regularly. Pregnancy tumors usually go away after pregnancy but if not you need an expert’s assistance to remove them.

Signs of oral problems during pregnancy

If you have found any of the following symptoms during pregnancy talk to your doctor.

·       Persistent bad breath

·       Lumps on the gum area

·       Mouth sores

·       Receding gums

·       The new room between the teeth

·       Loose teeth

·       Swollen or red gums

·       Toothache

You don’t need to wait longer to visit your doctor, call your gynecologist immediately. Their guidance can help you fight any type of health complications that are common to develop during this phase.

To schedule an appointment with the best gynecologist in Siliguri do visit New Ram Krishna Seva Sadan, the most successful fertility hospital in North Bengal.

[dentalimplantindia123]

Dental Health during Pregnancy and How to Avoid Common Dental Problems in Pregnancy?

Pregnancy is an incredible and beautiful time in any woman’s life. Whether the pregnancy was long awaited or was a complete surprise, there is nothing quite like the anticipation and excitement of preparing to meet a new born baby. However, this does bring with it, a package full of surprises for the mother-to-be.

Association Between Pregnancy And Dental Health

During pregnancy, the increased hormonal changes can majorly deteriorate the body’s response to plaque on the teeth and various microbial pathogens, thereby increasing the risk of dental diseases. The compromised dental health of the mother can further impact the health of the developing baby. The importance of dental hygiene is not often much stressed upon. The fact which is still unknown by most of the population is, infections that start in the mouth can spread to various parts of the body and these ill-effects shoot up during the pregnancy.

Common Dental Issues During Pregnancy

The two most commonly encountered dental problems by pregnant females are gum diseases and tooth decay. Research has found a considerable link between gum diseases in pregnant women and premature, low birth weight babies. It has been suggested that up to 18 out of every 100 premature birth could be linked to severe gum infection. This is a well recognized fact that babies who are born prematurely may be at an increased risk of developing a range of health conditions, be it cerebral palsy or hearing and visual deficits.

Gum Diseases – Signs And Symptoms:

Nearly 60-75% of pregnant women have gingivitis because the hormonal changes that occur due to pregnancy can make the gums more susceptible to plaque, which can trigger the initiation of inflammation and bleeding in gums, especially during tooth brushing and flossing, referred to as “Pregnancy Gingivitis” which is likely to occur during the first trimester.

What is Pregnancy Tumor?

If this condition is left untreated, it may result in Periodontal Diseases, which is the infection of the supporting structures of the teeth including gums, ligaments and bone. Furthermore, there may be an occasional occurrence of a red, round tissue overgrowth on the gums, referred to as “Pregnancy Epulis” or “Pyogenic Granuloma” or “Pregnancy Tumor”, which bleeds easily, can interfere with a woman’s ability to eat or care for her teeth and thereby, complicate the oral health considerably.

Tooth Decay And Morning Sickness:

Another major concern due to increased plaque deposits on teeth is the tooth decay, which occurs due to several reasons. The primary culprit being, the increased acidity in the mouth associated with the problem of morning sickness in the expectant mothers as it exposes the oral environment to more amount of gastric juices secreted by the stomach. The repeated reflux (regurgitation of food or drink) and associated vomiting can coat the tooth enamel with these strong gastric acids and destroy it.

Tooth Decay And High Sugar Intake:

The other common etiological factor of increased tooth decay is the unusual food cravings and snacking in-between the meals, particularly the sugary snacks. Also, women who have a lot of cavity-causing bacteria during pregnancy and after delivery can transmit these bacteria from their mouth to their baby’s mouth.

Home Oral Care Instructions:

Nevertheless, certain simple routine measures, if followed properly, can prove to be beneficial for both, the mother and the baby. Home oral care include brushing teeth thoroughly with fluoridated toothpaste twice daily; flossing between teeth once daily and mouth rinsing with an alcohol-free antimicrobial mouthwash; replacing the toothbrush every 2-3 months and using a soft bristle toothbrush; choosing a balanced diet plan rich in all the essential nutrients especially calcium, Vitamin B12 and C; significantly reducing the intake of high sugar content and snacking moderately only. Also, the consumption of tobacco products and alcohol must be avoided at all the times.

Why Should You Visit Your Dentist?

It is highly recommended to visit the dentist regularly for the routine check-ups as all pre-existing dental issues need to be resolved before planning for a child and if already pregnant, it is advised to inform the dentist about the pregnancy, it’s stage and other related information such as any special medical advice or medications received from the physician.

Professional Oral Health Care During Pregnancy

Undiagnosed or untreated periodontal diseases may worsen the condition and can lead to tooth loss. Hence, to avoid such unfavorable outcomes, it is crucial for the dentist to plan and execute the best possible oral health care. Preventive scaling or professional cleaning of the gums and teeth, cavity fillings and regular dental check-ups during pregnancy are not only safe but recommended.

Are Dental Procedures Safe During Pregnancy?

The benefits of receiving dental care during pregnancy far outweigh the potential risks. The safest time to undergo dental treatment is the second trimester of pregnancy. Sometimes, emergency dental procedures like tooth extraction/removal and root canal treatment can be performed following strict protocols. All elective dental procedures, such as teeth whitening, however, should be postponed until after the delivery.

With proper oral hygiene measures at home and professional help from your dentist, one can prevent any undue complications before, during and after the pregnancy.

Tag = dental clinic in delhi, dentist in Ashok Vihar, Dr. Sachdeva’s Dental Clinic, Gum Diseases, Oral Hygiene Tips, Pregnancy Oral Healthcare, tooth decay

[sg0000fan]

Removal Of Pyogenic Granuloma By Lasers

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[myspcae]

Common Skin Issues and Their Effective Solutions:

In the contemporary world, giving importance to skincare has become increasingly vital. If you're facing any of the concerns mentioned below, rest assured that there are effective solutions available. Alternatively, you may consider seeking the expertise of the best hair and skin clinic in Kolkata for professional guidance.

Acne and Acne Scars:

Acne, a prevalent skin condition, develops when hair follicles become blocked by oil, dead skin cells, and bacteria, leading to the formation of pimples, blackheads, and whiteheads. Acne can leave enduring marks on your skin, impacting your overall appearance.

Treatment: Dermatologists commonly recommend topical creams or gels containing ingredients such as benzoyl peroxide, salicylic acid, or retinoids for mild to moderate acne. These products help unclog pores, reduce inflammation, and prevent future breakouts.

For severe acne and the improvement of acne scars, the following treatments are available:

Oral Medications for Severe Acne:

Antibiotics: Tetracycline (minocycline, doxycycline) or macrolides (erythromycin, azithromycin) may be prescribed to combat bacteria and inflammation associated with acne.

Isotretinoin: An oral retinoid often prescribed for severe forms of acne. It reduces oil production and eliminates bacteria in the skin. It's crucial to use oral acne medications under medical supervision due to potential side effects.

Dermatological Procedures for Acne Scars:

Chemical Peels: This involves applying a chemical solution to exfoliate the top layers of skin, promoting the growth of new skin.

Microdermabrasion: A device gently exfoliates the skin, removing the outer layer and improving the appearance of acne scars.

Laser Therapy: Focused light beams target and remove scar tissue, stimulating collagen production and enhancing the appearance of acne scars.

Other options include dermal fillers, minor skin surgery, and subcision. Consulting with a dermatologist is essential to determine the best approach for treating acne scars based on individual factors.

Moles and Warts:

Dermatologists evaluate and treat moles and warts based on their characteristics. Treatment options include:

Moles:

Most moles are benign and require no treatment. However, changing or potentially cancerous moles may need to be removed.

Removal methods include cryotherapy, laser therapy, or surgical excision. Regularly monitoring changes in moles is crucial for detecting skin cancer, especially malignant melanoma.

Warts:

Caused by the human papillomavirus (HPV), warts can be treated with cryotherapy, laser therapy, surgical removal, or topical medications to eliminate or suppress the virus responsible for warts.

Other Benign Skin Growths:

Various growths such as dermatofibromas, dermoid cysts, freckles, keloids, keratoacanthomas, lipomas, and pyogenic granulomas are typically benign.

Seeking advice from a dermatologist is essential for addressing moles and warts and determining suitable treatments based on individual circumstances and skin type.

Hyperpigmentation Treatment:

To address uneven skin tone and dark spots, consider using topical products containing active ingredients like hydroquinone, vitamin C, arbutin, or licorice extract. These components effectively inhibit melanin production and promote a balanced skin tone.

Remedy: Consistent and dedicated application of these treatments can enhance your skin complexion and radiance. For personalized guidance tailored to your skin type and concerns, it's advisable to consult a dermatologist.

In Conclusion:

For precise diagnosis and appropriate treatments, the expertise of a dermatologist is indispensable. Their professional guidance can effectively address these skin concerns, restoring your skin's vitality and allure. Consider seeking treatment from Elation Hair and Skin Clinic, acknowledged as Kolkata's premier hair and skin clinic, for optimal and long-lasting skincare results.

[ourhaileydavies]

Juniper Publishers-Open Access Journal of Head Neck & Spine Surgery

Unilateral Bleeding Polyp in a Child: Lobular Capillary Hemangioma

Authored by Sourabha Kumar Patro

Abstract

  Epistaxis, though being common, always attracts special attention from medical professionals due to the nature of bleeding involved in the process. Children presenting with unilateral epistaxis warn otolaryngologists as the cause can vary from nasal foreign bodies to life threatening hemangiomas and angiofibromas. We present a rare case of lobular capillary hemangioma originating from nasal septum in a child who presented with episodes of profuse bleed. Early diagnosis and management with total excision was awarding. The occurrence is rare, however it should be in the differential diagnoses of unilateral nasal bleed in outpatient and emergency settings and strong suspicion is warranted.

Keywords:   Unilateral bleeding polyp in children; Nasal bleeding polyp; Unilateral nasal bleed; Lobular capillary hemangioma; Hemangioma of nose; Unilateral epistaxis

Introduction

  Lobular capillary hemangioma (LCH) is an acquired benign vascular proliferation of unknown origin, which was first described as human botromycosis by Poncet and Dor in 1897 [1]. Skin of head and neck and mucos membrane of the oral cavity are common sites but LCH is rare in the nasal cavity of children. The nasal septum is the most common affected nasal site, vestibule and middle turbinate being the other involved sites [2,3]. We present a case of lobular capillary hemangioma in a nine year old child who had presented with unilateral nasal bleed.

Case Report

  A nine year old child presented to the outpatient department of otolaryngology and head and neck surgery with 5 months history of recurrent nasal bleeding from left nasal cavity and left sided nasal obstruction. History of frequent nose picking present. On anterior rhinoscopy, single red fleshy lobulated mass of size 1.5x1.5cm was present in the left nasal cavity surrounded with blood clot. Contrast enhanced Computed tomography (CECT) of Paranasal sinus revealed a heterogeneously enhancing soft tissue lesion attached to the cartilaginous part of nasal septum (Figure 1). Rest of the head and neck and systemic examination was normal. Hence provisional diagnosis of a vascular nasal mass was made. Patient was planned for endoscopic excision under general anesthesia.

  Under general anaesthesia, after decongestion of bilateral nasal cavity, evaluation of the nasal mass was done. Endoscopic evaluation revealed a pinkish nasal mass which was arising from the cartilaginous part of the nasal septum (Figure 2). Stalk of the nasal mass was cauterized with bipolar cautery and the tumour was removed into to with sacrifice of 0.5cm surrounding mucosa at the site of attachment of the lesion. Adequate haemostasis was achieved. Anterior nasal packing was done.  Anterior nasal packs were removed after 24 hours and patient was discharged. The follow up of the patient was uneventful, Histopathological examination revealed the diagnosis of lobular capillary hemangioma. Microscopic examination showed biopsy tissue lined by focally ulcerated stratified squamous epithelium with underlying lobular arrangement of capillaries surrounding a large central vessel. The lumen of these capillaries varied from barely visible to large vascular spaces. The spindle shaped pericytic cells were seen in the periphery. No atypical mitotic figure or evidence of necrosis (Figure 3 & 4).

Discussion

  Lobular capillary hemangioma (LCH) was thought as pyogenic granuloma in earlier times but later denoted as misnomer because of non-infectious and non granulomatous nature. Present terminology of LCH is based on the characteristic histopathological findings described by Miller [4].

  Incidence of LCH is more in females as compared to males and is common in third decade of life [5]. Nasal cavity is an unusual site for LCH. Gingiva is a common site of lobular capillary hemangioma. Among the nasal sites, anterior septal mucosa and tip of turbinate's are the most frequent involved sites [1]. The presented case is that of a 9 year old male child who presented with a bleeding polypus of the anterior nasal cavity and which turned out to be LCH. The lesion in this case was found to be attached to the septal cartilage.

  Natural history and progression of LCH involves many contributing factors. These include trauma, hormonal imbalances, viral oncogenes, arterioveno malformation and angiogenic growth factors etc [6]. This child had a history of frequent nasal pricking, which could have led to repeated microtrauma and proliferation of vessels to form LCH attached to the nasal septum anteriorly. LCH have also been described as pregnancy tumour [7] due to increased associations with high levels of estrogen and progesterone during pregnancy.

  LCH usually presents with various symptoms such as unilateral epistaxis, nasal obstruction, nasal discharge, facial pain, headache etc depending on the site of lesion [6]. This patient had presented to our OPD with repeated episodes of left sided nasal bleed especially after nose pricking. Father of the child had noticed a small red mass in the left nasal cavity for which he brought the child into our outpatient department.

  CECT of the nose and paranasal sinuses is the preferred investigation for diagnosis of vascular lesions. Magnetic Resonance Imaging (MRI) with T2 weighted images reveal vascular soft tissue lesions with multiple flow voids [8].

  Criterion standard treatment in LCH has always been complete surgical excision of the lesion. Surgical technique and instrumentation used for such kind of lesions include cold instrumentation (with or without preoperative embolization), electrocoagulation, cryotherapy and LASER [9]. We did endoscopic excision of the hemangioma followed by cauterization of its base at the nasal septum which had the feeding vessels in it.

  Recurrences of the lobular capillary hemangioma are a rare occurrence. However, evidence in literature report a recurrence rate of 0 to 42% depending on the location, extent of removal and time of follow up [10]. This case has been followed up for 4 months till date and there is no evidence of recurrence of the lesion.

Conclusion

  Lobular capillary hemangioma of the nasal cavity is a rare entity especially in a male child in first decade of life. However, it should be considered as one of the differential diagnoses of unilateral epistaxis in children. High index of suspicion is the key for identifying such a lesion. Endoscopy guided complete surgical excision of the lesion is the management of choice for nasal lesions. Recurrence is rare with no malignant transformation reported till date.

For more articles in Open access Journal of Head Neck & Spine Surgery | Juniper Publishers please click on: https://juniperpublishers.com/jhnss/index.php

[tajskincare-blog]

At Dr Thaj Skin-Hair clinic, with CO2 laser we offer treatments for:

Warts, Corns & Skin tags

Rhinophyma

Multiple Trichoepithelioma

Epidermal Nevi

Xanthelasma Palpebrarum

Pyogenic Granuloma

Seborrheic Keratoses

Syringoma and various other skin growths

Super pulsed CO2 laser emits a colorless infrared light which is rapidly absorbed by the water contained in the skin tissues. Process is highly organized, focused for cutting the skin, defocused for superficially vaporizing the skin and super pulsed for resurfacing the skin to heal the irregularities caused by the wound. Along with Radio Surgery and Microdermabrasion, CO2 laser is suitable for skin re-surfacing & reduction of acne scars.

Advantages of CO2 Laser over traditional surgical methods

Total removal of infected tissues by vaporizations

Minimal Bleeding whilst surgery

Less post-treatment schedule & plan

Minimal post-operative complications

Minimal damage to the adjacent normal tissue

Minimal operative side effects

Reduced healing time

Epithelium is replaced with minimal scar formation

Sterile ablation

[goodbye--1989]

Goodbye 1989/I wanna be the one in control

Thanks @lafeelunaire for the tag!!

I tag anyone whomstve wants to do this lol

Name: Spooky

Gender: femmeale

Star sign: taurus

Height: 5 5

Middle name: (It’s kind of rare and Im uncomfty with saying it)

Put your playlist on shuffle, what do you get? 1-This Fire by Franz Ferdinand

2-Welcome to Tally Hall by Tally Hall

3-Evening Wear by Mindless Self Indulgence

4-You Reposted in the Wrong Neighborhood

5-Alarm Call by the Correspondents

6-Genious by Mindless Self Indulgence

Grab the closest book and turn to page 23. What’s line 17?

“The airbag goes off in my face, and I go flying backwards” from Rainbow Rowell’s Carry On

Ever had a poem or song written about you?

Not yet

When was the last time you played air guitar:

Not too long ago I think? Im usually listening to music that calls for air guitar

Celeb crush?

Chris. You tell me which one (I dont rlly crush on celebrities)

Hate:

Being unable to leave a scenario... Im bad at making things awkward fast and  being unable to leave rip

love:

Flowers, plants, writing, and improving horror stories

Do you believe in ghosts? aliens?

Ghosts no, aliens yes.

Do you drive? If so have you crashed?

No and no

Last book you read? 

Carry On by Rainbow Rowell

Last movie you saw?

Little Monsters

Worst injury youve had?

Not really an injury but I had a pyogenic granuloma, a bloody tumor, as a kid that grew as big as a cherry pit. That had to get removed

Any obsessions at the moment? 

Nah. Its kind of boring

Do you hold grudges against people who have done you wrong?

Binch I hold grudges against Myself of course I hold grudges against others

In a relationship

Tecnically yea