title: Should pyogenic granulomas following burns be excised?
abstract: BACKGROUND
  Patients with pygenic granuloma following burns (PGB) presents dramatic clinical features which are different from those with classic pyogenic granuloma. This review aims to discuss whether pyogenic granuloma following burns (PGB) need excision or not.
  
  
  METHODS
  Using the PubMed, EMBASE, Cochrane Library and web of science databases. All articles which discussed diagnosis and treatment of pyogenic granuloma following burns with histological results were included from 1978 to 2013. Reports from meetings were not included. Only articles published in English were included.
  
  
  RESULTS
  Twenty one articles excluded from a total of 32 studies. One study was excluded from the 11 descriptive studies because of typical histological results. The rest, 10 studies were case reports. Only one article was published in French, whose abstract was published in French and English. Patients with PGB presented six distinctive clinical features. First, all the patients had burns initially. The second, PGB acutely erupted between 1 and 4 weeks in patients' burned area, which may be infected by bacteria, fungus and virus. The fourth, PGB can be classified into proliferative and shrivelling stages. The fifth, three hisiological characteristics including hyperkeratosis or acanthosis, numerous newly formed proliferative vascular, edematous stroma with infiltration by plasma cells and lymphocytes. Finally, recurrence, 6 out of 16 patients with PGB involuted spontaneously with no recurrence. Three out of 16 patients were conservatively managed with no recurrence, neither patients (5) who had surgery and 2 patients treated with electro coagulation had recurrence.
  
  
  CONCLUSIONS
  PGB lesions are benign based on clinical features and histological examinations. The clinical process of PGB could be divided into proliferative and shrivelling stages. Conservative treatment including wound management and antibiotic could be chosen firstly, especially when large PGBs are on the face or other important area of one's body. When conservative treatment is ineffective, a surgery could be chosen.
authors.affiliation: General Hospital of PLA, Trauma Center of Postgraduate Medical College , 28 Fu Xing Road, Beijing 100853, PR China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Key Laboratory of Wound Repair and Regeneration of PLA, The First Affiliated Hospital (304th Hospital), General Hospital of PLA, 51 Fu Cheng Road, Beijing 100048, PR China.
authors.forename: Sha
authors.initials: S
authors.lastname: Huang
authors.affiliation: General Hospital of PLA, Trauma Center of Postgraduate Medical College , 28 Fu Xing Road, Beijing 100853, PR China; Key Laboratory of Wound Repair and Regeneration of PLA, The First Affiliated Hospital (304th Hospital), General Hospital of PLA, 51 Fu Cheng Road, Beijing 100048, PR China. Electronic address: fuxiaobing@vip.sina.com.
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Fu
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001458:Bandages; D002056:Burns / Q000150:complications*; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D017789:Granuloma, Pyogenic / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents
keywords: Burns; Graft; Pyogenic granulomas; Scar