A pyogenic granuloma initially presents as a bright red, shiny papule with a thin collarette of hyperkeratosis. It may be ulcerated and tends to bleed profusely with minor injury. Later, the lesion reepithelializes and becomes a dull red to purple color. Although these lesions can occur anywhere on the body, the extremities, especially the hands, are the most common sites of involvement. The differential diagnosis includes amelanotic melanoma, squamous cell carcinoma, bacillary angiomatosis, and cutaneous metastasis.
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