Oral pyogenic granulomas: a rare manifestation of oral graft-versus-host-disease
DOI:
https://doi.org/10.46765/2675-374X.2025v7n1e331Keywords:
Case Reports, Granuloma, Pyogenic, Graft vs Host Disease, Hematopoietic Stem Cell TransplantationAbstract
Background: Chronic graft-versus-host disease (cGVHD) is a frequent complication following allogeneic hematopoietic cell transplantation (allo-HCT) and commonly affects the oral cavity. Up to 80% of patients develop oral manifestations, which may significantly impair quality of life, especially in pediatric patients. Objective: To describe the diagnosis and management of a pyogenic granuloma in a pediatric patient with oral cGVHD. Case report: A 5-year-old male patient underwent a second haploidentical allo-HCT for severe aplastic anemia. On day +270 post-transplantation, he developed painful ulcerative lesions on the bilateral buccal mucosa and lateral borders of the tongue, which evolved into ulcerated nodular lesions. Initial conservative management with topical 0.1% clobetasol propionate was attempted, without clinical improvement. Due to lesion progression and persistent pain, the patient was referred to the surgical center for excision of the nodules. Histopathological examination was consistent with pyogenic granuloma. Seven days after surgery, recurrence was observed on the right buccal mucosa. Topical treatment with 0.1% clobetasol propionate was attempted, without clinical improvement. Due to lesion progression and persistent pain, the patient was referred to the surgical center for excision of the nodules. Histopathological examination was consistent with pyogenic granuloma. Seven days after surgery, recurrence was observed on the right buccal mucosa. Topical treatment with 0.1% clobetasol propionate ointment associated with acetate plates was prescribed, leading to regression of the recurrent lesion. Conclusion: Complete surgical excision associated with elimination of local traumatic factors remains the standard treatment, while adequate control of the underlying oral cGVHD may contribute to favorable clinical outcomes.
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Copyright (c) 2026 Maria Julia Pagliarone, Thiago Carvalho Reis, Giovana Dornelas Azevedo Romero, Tatiane Cristina Ferrari, Carlos Eduardo Settani Grecco, Luiz Guilherme Darrigo Junior, Joana Teresa Bisinella de Faria, Rodrigo Braz Campos, Thalita Cristina de Mello Costa, Ana Beatriz Pereira Lima Stracieri; Lara Maria Alencar Ramos Innocentini; Hilton Marcos Alves Ricz; Leandro Dorigan de Macedo
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