Pyogenic granuloma following oculoplastic procedures: An imbalance in angiogenesis regulation?

Background: Pyogenic granuloma is a vasoproliferative inflammatory response composed of granulation tissue. The pathogenesis is not entirely clear. We describe a series of patients with pyogenic granulomas occurring following common oculoplastic procedures and propose a common etiology. Methods: Sixteen cases of pyogenic granuloma that occurred after various oculoplastic procedures from 1991 to 2000 were collected from the files of two oculoplastic surgeons. Results: Pyogenic granulomas were found to occur at surgical and nonsurgical sites associated with tissue irritation or inflammation or both. Interpretation: Capillaries are a predominant component of wound healing and pyogenic granulomas. The growth and development of new capillaries follows an orderly sequence of events that is highly regulated by a variety of angiogenic factors. We postulate an imbalance in angiogenesis regulation as the common pathway for pyogenic granuloma development.