Sequential pulsed dye and Nd:YAG laser therapy for deep venous malformation presenting as recurrent Pyogenic granuloma

Pyogenic granuloma may recur when an underlying vascular anomaly remains untreated. We report a case of recurrent pyogenic granuloma of the finger pulp associated with a deep venous malformation successfully treated using sequential dual-wavelength pulsed dye laser (PDL, 585–595 nm) and Nd:YAG laser (1064 nm). Four sessions were performed at three-month intervals (PDL 6 J/cm2; Nd:YAG 50 J/cm2; 10-mm spot; long delay sequential mode) with integrated cooling. Complete clinical resolution was achieved without adverse effects or recurrence after five years. Sequential PDL–Nd:YAG therapy represents an effective etiologic approach for complex vascular lesions involving both superficial and deep components.