Topical β-Blocker as a Novel Treatment Option for Periungual Pyogenic Granuloma: A Retrospective Study of Lesion Size Reduction and Pain Improvement.

Periungual pyogenic granuloma (PG) is a benign reactive vascular lesion commonly associated with trauma and/or drug exposure, including anticancer therapies such as epidermal growth factor receptor (EGFR) inhibitors and other targeted agents. These lesions often cause pain, bleeding, and functional impairment, and may lead to interruption or dose reduction of relevant anticancer treatment. However, there remains a need for effective and noninvasive treatment options that can be easily administered in clinical practice. This study aimed to evaluate the clinical effectiveness and safety of topical timolol in patients with periungual PG. A total of 12 patients were treated with topical timolol 0.5% applied twice daily. Clinical outcomes, including lesion size, pain visual analog scale (VAS), and Dermatology Life Quality Index (DLQI), were assessed at baseline, Week 4, and Week 8. Lesion size decreased significantly over time (p = 0.003), with a significant reduction observed at Week 8 compared with baseline (p = 0.002), corresponding to a mean reduction of 60.3% at week 8. Pain VAS significantly improved at both Week 4 (p = 0.043) and Week 8 (p < 0.001), with a mean reduction of 65.5% at Week 8 compared with baseline. DLQI also improved but did not show a statistically significant change. No significant adverse events, including significant changes in blood pressure or heart rate, were observed. In conclusion, the study suggests that topical timolol is a safe and effective treatment for periungual PG, making it a valuable supportive care strategy for patients undergoing anticancer therapy.