Pyogenic granuloma is a common reactive neoformation of the oral cavity, which is composed of granulation tissue and develops in response to local irritation or trauma. Various names have been given to this entity, reflecting, in part, mistaken concepts about its aetiology and pathogenesis: botryomycosis hominis, botryomycoma, telangiectatic granuloma, benign pedunculated granuloma, fibroangioma, septic granuloma, hemangiomatous granuloma, lobular capillary hemangioma, etc).
The most widely used term is pyogenic granuloma, although it does not adequately describe the lesion’s characteristics. The term “pyogenic” implies pus production related to an infectious aetiology; however, no pus-producing microorganisms are associated with pyogenic granuloma. Moreover, the lesion is not a true “granuloma” (i.e. a specific type of persistent chronic inflammation).
Pyogenic granuloma is not an infectious but a reactive lesion, due to local irritating factors (in this case, tongue piercing). Therefore, it is included in the large group of inflammatory hyperplasias: neoformations due to increase in the number of constituent cells and not genuine tumours in the sense that their excessive growth is not autonomous but depends on a continuous stimulus of traumatic nature.