Treatment efficacy of sclerotherapy by polidocanol vs. bleomycin for pyogenic granuloma in children: A comparative study

Pyogenic granuloma (PG) is a benign vascular skin lesion that occurs in children. Although, sclerotherapy is a common treatment for patients with PG, all the previous studies have been case reports or series. At present, no reports have compared the efficacy of the two different sclerosing agents, polidocanol and bleomycin, in the treatment of PG. Therefore, we aimed to compare the cure rates and adverse reactions associated with these two agents in sclerotherapy for PG in children. This retrospective analysis included children <18 years of age with PG undergoing cutaneous treatment at our hospital between January 2016 and January 2022. Two sclerosing agents, polidocanol and bleomycin, were topically injected. The efficacy and incidence of adverse reactions were compared between the two groups. A total of 117 children with PG were divided into the polidocanol ( n =52) and bleomycin ( n =65) groups. Lesions disappeared after one injection in 38 children, two in 11 children, and three in 3 children in the polidocanol group. A similar phenomenon was observed after one injection in 53 children, two injections in 8 children, and three injections in children in the bleomycin group. The single-injection cure rate was not significantly different between the two groups ( P >0.05). The rate of adverse reactions was significantly different between the two groups ( P <0.05). No severe complications occurred, and no recurrences were detected during the 6–12 months of postoperative follow-up period. This study showed that both polidocanol and bleomycin are safe and effective sclerosing agents for treatment of PG in children. The incidence of adverse reactions to polidocanol was lower than that to bleomycin. We recommend sclerotherapy with polidocanol as a first-line treatment for PG, as it is suitable for application in hospitals at various levels.