LAUSR

DEAR EDITOR, A 61-year-old man presented for an enlarging, bleeding, 2-cm nodule on the philtrum for 3 months consistent with a pyogenic granuloma. Three weeks later, on the day of scheduled removal, he presented with profuse bleeding, anaemia (haemoglobin 7 g dL ; baseline 14 1 g dL ) and hypotension (60/36 mmHg). Work-up for other aetiologies was unremarkable. He recovered with fluid resuscitation, transfusion and excision. This presentation was likely due to his lesion as no other cause has been identified. Rarely oral and gastrointestinal lesions have caused similar events. Our case calls attention to the possibility that a cutaneous pyogenic granuloma can cause haemodynamic instability.