A pyogenic granuloma may occur under and adjacent to a nail.

On clinical exam there is a reddish subungual pr periungual mass that may bleed or be painful.


Biopsy of the mass shows a benign hemangioma with variable low-grade inflammation.


Drug therapy associated with periungual or subungual pyogenic granuloma:

(1) paclitaxel or docetaxel

(2) rituximab

(3) isotretinoin

(4) levothyroxine

(5) anti-TNF alpha

(6) mitozantrone

(7) imatinib


Other causes may include:

(1) pregnancy

(2) trauma


Differential diagnosis:

(1) subungual exostosis

(2) subungual glomus tumor

(3) subungual melanoma

(4) subungual squamous cell carcinoma

(5) subungual fibroma

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