A previously healthy girl aged 5 years was brought to the emergency department with pain in the left eye of 48 h duration. Her mother had also noticed a mucosal protrusion in the eyelid from the week before. There was no vision impairment and the child had no other symptoms.

The physical examination evidenced the presence of conjunctival hyperaemia and a flat mucosal protrusion measuring 0.5 cm in length on eyelid abduction (video, Supplementary data). A consultation was made with the on-call ophthalmologist, and the patient received a prescription for topical dexamethasone and gentamicin to be applied every 8 h. She was evaluated again 4 days later, with evidence of a significant decrease in lesion size followed by complete resolution after 1 week of treatment.

Pyogenic granuloma is a rapidly growing vascular lesion thar occurs in the skin or mucosa, more frequently in the second or third decade of life.1 Although benign, these lesions can cause discomfort, and sometimes bleed with little trauma.2 Pain is not a common complaint, but children often have difficulty reporting symptoms. The diagnosis is clinical, although in some cases, a histopathological examination may be useful for confirmation. Most pyogenic granulomas resolve spontaneously,3 although topical steroid therapy or surgical resection may be necessary for particularly uncomfortable or long-lasting lesions.1