Topical Timolol in the Treatment of Hemodialysis Tunneled Catheter Exit-Site Pyogenic Granuloma

Pyogenic granuloma (PG) is a benign vascular proliferation of the skin and mucous membranes that can occur spontaneously or inresponse to trauma, skin irritation, viral pathogens, or drugs. The clinical presentation consists of small friable red papules or nodules. Although the pathogenesis of PG is unknown, it has been hypothesized that local tissue hypoxia or trauma induces the aberrant expression of vascular endothelial growth factor. Various surgical treatments recommended for PG may be invasive or have adverse effects, have no response, or there may be recurrence; therefore, noninvasive treatment is favored.