Pyogenic granuloma: complete remission under occlusive imiquimod 5% cream

An 82-year-old man was referred to our department for evaluation and treatment of a recurrent pyogenic granuloma on his right hand. After previous histopathological confirmation of the clinical diagnosis, he had been treated twice with electrocautery, but the lesion recurred 10 and 8 days later, respectively. After a 3-week topical application of imiquimod 5% cream twice daily under occlusion, complete remission of the lesion was achieved. Apart from an erythematous reaction in the apparently normal surrounding skin, the patient experienced no local or systemic side-effects. Since discontinuation of treatment he has been followed up for 8 months, and there has been no recurrence.