Pyogenic granuloma clinically and dermoscopically mimicking pigmented melanoma

Pyogenic granuloma is a common, benign, acquired, vascular growth of skin and mucous membranes that usually presents as a solitary, rapidly, growing, papule or polyp that bleeds easily after minor trauma. The clinical diagnosis of this lesion is usually straightforward. Moreover, the dermoscopic features associated with pyogenic granulomas have been described recently. However, occasionally this tumor can be difficult to differentiate clinically and dermoscopically from other pigmented and vascular lesions. We report the case of an 18-year-old male who presented with a round, purple-black nodule with hemorrhagic crust, 1 cm in diameter, located on the lower part of the thorax. Dermoscopic evaluation revealed the presence of a blue-white veil, a black blotch, polymorphous atypical vessels, milky-red areas, and hemorrhagic crusts. The subsequent histopathological examination revealed a pyogenic granuloma. We present a case of pyogenic granuloma clinically and dermoscopically indistinguishable from a pigmented malignant melanoma.