Etiology • A reactive hyperplasia of capillaries and fibroblasts • Related to chronic, persistent trauma or irritation (eg, calculus
or foreign body) • Misnomer—neither pyogenic nor granulomatous
Clinical Presentation • Occurs at any age, but usually in children, young adults, and
women • Red, lobular to smoothly contoured appearance • When ulcerated, a yellow fibrinous exudate covers the lesion. • Sessile to pedunculated commonly on gingiva, but also on
areas that are traumatized (eg, lower lip, buccal mucosa) • Bleeds easily but is painless
or foreign body) • Misnomer—neither pyogenic nor granulomatous
Clinical Presentation • Occurs at any age, but usually in children, young adults, and
women • Red, lobular to smoothly contoured appearance • When ulcerated, a yellow fibrinous exudate covers the lesion. • Sessile to pedunculated commonly on gingiva, but also on
areas that are traumatized (eg, lower lip, buccal mucosa) • Bleeds easily but is painless
Microscopic Findings • Hyperplastic granulation tissue • Often lobular aggregation of proliferative vascular tissue • Acute and chronic inflammation may be present, especially if
ulcerated
Diagnosis • History of gradual to rapid onset • Identification of a stimulus or causative factor (eg, trauma,
physical irritant) • Histologic evaluation
Differential Diagnosis • Peripheral giant cell granuloma • Peripheral ossifying fibroma • Metastatic tumor • Kaposi’s sarcoma • Vascular malformation
Treatment • Local excision, scalpel excision
• Laser ablation • Electrosurgery
Red/Blue Lesions 51
• If on gingiva, excision should be extended to the periosteum or periodontal ligament
Prognosis • Excellent • Recurrence occasional