Lobular capillary hemangiomas: An epidemiologic report, with emphasis on cutaneous lesions

Background: Lobular capillary hemangiomas (pyogenic granulomas) occur on bo th mucosal and cutaneous surfaces. There are conflicting data regarding the increased prevalence of lobular capillary hemangiomas in female versus mal e subjects. Some studies have noted a female predominance of lobular capill ary hemangiomas, but other studies do not reveal such a disparity. Because of an increased prevalence during pregnancy, oral tumors are also known as "granuloma gravidarum" or "pregnancy tumors." A hormonal influence for thes e mucosal lesions has been postulated. There are, however, no studies that address a possible relationship between hormones and cutaneous lesions. Objective: This study presents the epidemiology of lobular capillary hemang iomas, with an emphasis on cutaneous lesions. Methods: We reviewed 63,759 dermatopathology reports from a regional, priva te dermatopathology laboratory and found 325 cases of lobular capillary hem angiomas over a 1-year period. Results: In our study of lobular capillary hemangiomas, cutaneous lesions a ccounted for 86%, with mucosal lesions representing only 12% of cases. Seve n cases were excluded (one was intravascular, two were subcutaneous, and in 4 the location was not specified). Overall, male patients outnumbered fema le patients. The peak incidence for cutaneous lobular capillary hemangiomas was found in the second decade of life. The most common cutaneous sites we re the trunk, upper extremities, and head. Mucosal lesions were primarily s een on the lips, gingiva, and tongue, and these affected females more than males by a ratio of 2:1, most commonly in the fourth decade of life. Conclusion: Cutaneous lobular capillary hemangiomas were equally prevalent in male and female patients. This would refute a female hormonal influence in the induction of cutaneous lobular capillary hemangiomas. Our data may s uggest a hormonal influence on mucosal lesions because mucosal lobular capi llary hemangiomas were twice as common in female patients. However, the sma ll number of lesions in our study precludes us from making such a conclusio n.