Sir,
Pyogenic granuloma (PG), also referred to as lobular capillary hemangioma,[1] is a bright red-brown benign vascular tumor with a thin intact epidermis. It usually occurs following trivial trauma and common sites of occurrence are extremities, face, upper trunk, and mucosal surface of mouth. We herein report a case of PG at then ear piercing site.
A 25-year-old female presented to our skin clinic with a nodular lesion over the right ear since two months, which had developed as a papule 3 weeks after ear boring. She denied history of developing similar lesions at the other ear bored sites [Figure 1]. Excision biopsy of the lesion revealed thinned-out epidermis forming a collarette with capillary proliferation embedded in an edematous stroma in the dermis [Figure 2].
Figure 1.
Ulcerated nodule over the right ear
Figure 2.
Histopathology image showing thinned-out epidemis with proliferation of capillaries in dermis (H and E, ×100)
DISCUSSION
Ear piercing (karna vedha) is Hindu religious custom practised extensively in India. While some believe that the pierced ears help ward off evil, others pierce their ears for purely aesthetic reasons. Customarily, a baby's ears are pierced during the first year of life. In a study of 100 women who had had both nose and ear piercing done, 33 gave a history of PG developing at the site of the nose piercing, but none had developed such a lesion at the ear boring site. The authors of this study suggest that the tissues of the alae nasi are abnormally susceptible to this type of reaction. Lesions were usually seen on the outer aspect of the alae nasi and only occasionally on the inner aspect.[2] Simo et al., report two cases of children, probably nose pickers with intranasal PG.[3] It is noteworthy that other granulomatous skin lesions were considered in the diffential diagnoses in our patient. Chiefly, a foreign body granuloma was thought of as also some infective granulomas of fungal origin. But the clinical picture was classical and the biosy was clinching. We report this case for the rarity of PG at the ear piercing site.
REFERENCES
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