M.O is a 37 years old man complaining of a sudden small growth with continuous bleeding on his fi nger, erythematous, painless papule lesion (fi gure1). Th e lesion was very small in size, fi rm and shiny when fi rst noticed by the patient. No history of trauma or accident in that area. It was tender to touch with a tendency to bleed more if touched. Th e patient tried topical antibiotics for one month before he went to seek medical assistance (fi gure2). When the bleeding couldn’t be controlled by antibiotics, he went to a GP for a general checkup. Th e GP diagnosed the bleeding as a superfi cial infection and pescribed oral cefi xime 400 mg once daily for 7 days plus topical fucidic acid ointment twice daily for one month (fi gure3). Figure 3 shows there was no improvement after the antibiotic course. A dermatologist was seen after that and diagnosed it as a pyogenic granuloma. A second opinion from another dermatologist was taken to confi rm the diagnoses. Th e dermatologists decided that there was no need for biopsy at the moment because of the small area of bleeding.