{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:11:42Z","timestamp":1784200302563,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:00:00Z","timestamp":1720137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cutaneous pyogenic granulomas (PGs) are common, benign vascular tumors of uncertain pathogenesis; however, a growing body of literature suggests that the formation of PGs may be secondary to genetic alterations in both the Ras\/Raf\/MAPK and PI3K\/Akt\/mTOR pathways. We present three cases of spontaneous multifocal PGs that first presented in infancy, were not associated with other vascular anomalies or discernable etiology, harbored somatic genetic variants in the Ras\/Raf\/MAPK pathway (<jats:italic>NRAS n<\/jats:italic>\u2009=\u20092, <jats:italic>FGFR1 n<\/jats:italic>\u2009=\u20091), were refractory to treatment with beta\u2010blockers and mTOR inhibitors, and responded best to pulsed dye laser. We propose the term \u201cspontaneous multifocal PGs\u201d to describe this entity.<\/jats:p>","DOI":"10.1111\/pde.15672","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T15:44:01Z","timestamp":1720194241000},"page":"1134-1140","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Spontaneous multifocal pyogenic granulomas"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2412-9290","authenticated-orcid":false,"given":"Lindsey J.","family":"Gaghan","sequence":"first","affiliation":[{"name":"Department of Dermatology The Warren Alpert Medical School of Brown University  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac T.","family":"Sluder","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwath","family":"Sampath","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeyhan","family":"Wood","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery University of North Carolina School  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Brondon","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology Oncology University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Blatt","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology Oncology University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayson","family":"Miedema","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of North Carolina  Chapel Hill North Carolina USA"},{"name":"Department of Dermatopathology, Department of Dermatology University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Nieman","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.14268"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2006.10.018"},{"issue":"7","key":"e_1_2_6_4_1","first-page":"860","article-title":"Congenital and disseminated pyogenic granuloma\u2010like vascular lesions","volume":"95","author":"Mallet S","year":"2015","journal-title":"Acta Derm Venereol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2020.06.079"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2008.00858.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.12700"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr.11.2011.5162"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2015.10.059"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/JID.2015.376"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2015.55"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004294"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2019.09.002"},{"key":"e_1_2_6_14_1","first-page":"134","article-title":"Disseminated granuloma pyogenicum","volume":"50","author":"Juhlin L","year":"1970","journal-title":"Acta Dermatovener"},{"issue":"11","key":"e_1_2_6_15_1","first-page":"428","article-title":"Multiple pyogenic granulomata","volume":"70","author":"Frain BW","year":"1958","journal-title":"Br J Dermatol"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000372-198610000-00003"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-020-00222-7"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-6147(00)01676-X"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells10113242"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40478-020-00898-6"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt419"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yexmp.2014.06.010"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2021.663272"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.36836"},{"issue":"6","key":"e_1_2_6_25_1","first-page":"1460","article-title":"Clinical and molecular spectrum of sporadic vascular malformations: a single\u2010center study","volume":"10","author":"Diociaiuti A","year":"2022","journal-title":"Biomedicine"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2008.03.011"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI98589"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.14912"}],"container-title":["Pediatric Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.15672","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T08:55:36Z","timestamp":1732092936000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pde.15672"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,5]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/pde.15672"],"URL":"https:\/\/doi.org\/10.1111\/pde.15672","archive":["Portico"],"relation":{},"ISSN":["0736-8046","1525-1470"],"issn-type":[{"value":"0736-8046","type":"print"},{"value":"1525-1470","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,5]]},"assertion":[{"value":"2023-09-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}