Pyogenic granuloma presenting as a congenital epulis.

OBJECTIVE To describe a clinical approach to the differential diagnosis of oral lesions in neonates. DESIGN Case report. SETTING Academic ambulatory care center. PARTICIPANTS Male infant. RESULTS A gingival mass in a male infant appeared clinically consistent with a congenital epulis. Following excision and histologic examination, the diagnosis was determined to be a pyogenic granuloma. Careful attention to alternative diagnoses led to the correct etiology. CONCLUSIONS Primary care pediatricians encounter neonatal oral lesions infrequently. The most common oral lesions in the newborn period are Epstein pearls and Bohn nodules. This case illustrates the importance of formulating a more extensive differential diagnosis on discovery of a neonatal oral mass.