A 53-year-old woman felt the underwire in her bra stab the inframammary skin. She covered the ensuing shallow wound with antibiotic ointment under a bandage. The wound was slow to heal, and was ultimately replaced by a friable, oozing papule.
Key point: The constant serous ooze and intermittent bleeding after minimal trauma, combined with the purple-red color of this lesion all suggest the proper diagnosis: pyogenic granuloma. These benign vascular tumors are often, though not always, associated with antecedent trauma.
Treatment: The lesion was completely excised.
Note: Pyogenic granulomas do not often respond well to simple electrocautery or to liquid nitrogen cryosurgery. These simple modalities may result in prompt recurrence.