History:

Pyogenic Granuloma a vascular tumour that develops rapidly, often at the site of a recent injury and is composed of proliferating capillaries in a loose stroma. It has bright-red to blue-black colour and may bleed very easily.  The size varies between 5 and 10mm, but at times it may reach 50mm. The commonest involved sites are the hands, especially on the fingers, the feet, lips, head and upper trunk, and the mucosal surfaces of the mouth and perianal area. The initial evolution is rapid and after a few weeks the growth ceases. This man had planter wart on the under surface of the big toe cauterized 3 weeks earlier to presentation with this rounded, eroded,  vascular tumour which bled easily on slight touch.