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Amelanocytic melanoma

A malignant tumor that can mimic this lesion but is often firmer, may grow more slowly, and can only be definitively excluded by biopsy.

B cell lymphoma

Presents as violaceous nodules or tumors ('plum-colored'), which are firm and non-friable, unlike the typically bright red and easily bleeding pyogenic granuloma.

Haemangioma

A true vascular proliferation that is typically present from infancy (cherry angioma in adults) and does not grow as rapidly as a pyogenic granuloma.

Metastatic deposit

Usually a firm, non-friable nodule that can be skin-colored or violaceous and should be suspected in a patient with a known history of internal malignancy.

Orf

A viral infection acquired from sheep or goats, presenting as a large, inflammatory nodule with a central umbilication or hemorrhagic crust, often with a history of animal contact.

Squamous cell carcinoma

Can present as a nodule but is typically firmer, more indurated, and may have a hyperkeratotic surface rather than a friable, vascular one.

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