Dermatology Online Journal

A pyogenic granuloma (PG) is a rapidly growing benign vascular tumor that can be found on the skin or subcutaneous tissue.  While some pyogenic granulomas may resolve spontaneously, most have a tendency to bleed easily and require treatment.  Current therapeutic modalities include topical imiquimod, cryotherapy, electrodessication, curettage, excision, laser therapy, sclerotherapy, and microembolization. We report a recalcitrant case of chronic pyogenic granuloma occurring on the scalp of a healthy young male which was unresponsive to conventional surgical and non-surgical modalities.  Ultimately, aggressive laser therapy, intralesional triamcinolone acetonide injections, and topical timolol application led to complete resolution and healing.