Dr Finola O’Sullivan¹, Dr Rachel Khoo¹, Mr Sandeep B¹, Professor Fiona Wood¹, Ms Helen Douglas¹

¹State Adult Burns Unit, Fiona Stanley Hospital, Murdoch, Australia

Abstract:

Introduction:

A 51 year-old male sustained a scald to the volar aspect of his left little finger whilst cooking. Assessed as superficial dermal in nature by his GP, it was treated conservatively. However, after 7 weeks the wound had not healed and remained friable. It was treated by various clinicians with a combination of dressings, topical corticosteroid, and cryotherapy.

He was referred to the WA State Adult Burns Unit where, after further review, diagnosis of a vascular anomaly was considered likely.

The patient underwent excision and closure of the lesion which healed uneventfully. Histopathology concluded a capillary haemangioma (CH), and there has been no recurrence to date.

Discussion:

Pyogenic granuloma (PG) is a commonly acquired lesion, easily recognisable as a vascular tumour of the skin and mucosa. CH are clinically similar lesions to both PG and infantile haemangioma. (Sharquie, Al-Dhalimi et al. 2021) They typically present in the first year of life, though have been described after trauma.(Habibi, Agrawal et al. 2009)

Trauma is among the pre-disposing factors for both PG and CH, and incidences post-burn have been reported. (Zhao, Huang et al. 2015, Staggers, Pearson et al. 2019) Lesion onset is typically within 4 weeks from the point of injury and diagnosis is confirmed with excision and histopathological examination. (Staggers, Pearson et al. 2019)

We present the unusual case of a lesion post-burn injury for which histopathology demonstrates CH.

Conclusion:

This case highlights the need to consider alternative diagnoses in non-healing burns and serves as a reminder that vascular anomalies such as PG and acquired CH can present post-burn. A degree of suspicion is warranted upon the development of a new vascular lesion overlying recent burn injuries.

Biography:

Dr O’Sullivan is a graduate of University College Dublin, Ireland. She has had the opportunity to travel to Australia to continue her early medical career, with a particular interest in surgery. This has included an invaluable term spent on the SABU in Fiona Stanley Hospital, Western Australia.