The pyogenic granuloma often appears suddenly and is a rapid growing vascular tumor which usually occurs at a site of trauma. They are known to bleed easily and become quite large. The use of the carbon dioxide laser is extremely effective in managing these tumors. The use of a little intradermal local anesthetic at the tumor base greatly reduces bleeding with the procedure. The entire lesion can be curetted or tangentially excised. The base is then lightly vaporized with the laser. Minimal scarring is seen. The amelanotic melanoma can mimic the pyogenic granuloma, making pathological examination mandatory for these lesions. See photos of these lesions and amelanotic melanoma image number 58.