Er, Cr: YSGG Laser Excision of an Ulcerated Pyogenic Granuloma of the Upper Lip Vermilion in a Child Initially Diagnosed as Hemangioma: A Case Report

Background: Pyogenic granuloma is a benign reactive vascular lesion frequently encountered in the oral cavity, most commonly on the gingiva. Localization on the vermilion border of the lip is uncommon, particularly in pediatric patients, and may present a diagnostic challenge because of its clinical resemblance to hemangiomas and other vascular lesions. Laser-assisted surgery has been introduced as a minimally invasive alternative to conventional surgical excision. Case presentation: A 10-year-old girl presented with a vascular lesion located on the left lateral aspect of the upper lip vermilion. The lesion had been present for approximately one year and was initially diagnosed as a hemangioma after consultations with several specialists. During the two months preceding treatment, recurrent episodes of spontaneous bleeding were reported. Complete excision was performed on 07 May 2026 using an Er, Cr: YAG laser (Waterlase iPlus®, BIOLASE, Irvine, CA, USA). Histopathological examination confirmed an ulcerated pyogenic granuloma (Granuloma pyogenicum ulceratum) with negative peripheral and deep surgical margins. Results: The procedure was completed under minimal local anesthesia with satisfactory intraoperative hemostasis and without the need for suturing. Healing progressed uneventfully, with progressive epithelialization and no signs of infection, prolonged bleeding, functional impairment, or recurrence. Follow-up demonstrated preservation of the normal lip contour and a highly satisfactory esthetic outcome. Conclusion: Er, Cr: YSGG laser excision may represent a safe and effective minimally invasive treatment option for pyogenic granuloma of the upper lip vermilion in pediatric patients. The technique provides precise tissue removal, satisfactory hemostasis, favorable healing, and highly satisfactory esthetic results.