Venous lake

A venous lake (also known as phlebectasis[1]) is a generally solitary, soft, compressible, dark blue to violaceous, 0.2- to 1-cm papule commonly found on sun-exposed surfaces of the vermilion border of the lip, face and ears.[2][3][4] Lesions generally occur among the elderly.[5][6]

Venous lake
Venous lake of the lip
SpecialtyDermatology 

Though these lesions may resemble nodular melanoma, the lack of induration, slow growth, and lightening appearance upon diascopy suggest against it, and indicate a vascular lesion.[7] Additionally, lack of pulsation distinguishes this lesion of the lower lip from a tortuous segment of the inferior labial artery.[4]

Cause

The cause is unknown; however it is thought to be associated with sun exposure, leading to a dilated blood-filled vascular channel[2] "...lined with a singled layer of flattened endothelial cells and a thin wall of fibrous tissue filled with red blood cells."[7]

Treatment

Treatment may be requested for cosmetic reasons. Traditional techniques such as surgical excision are effective but will leave a scar. Laser therapy has become the mainstay of therapy. Published research suggests that the Long Pulsed Nd:YAG laser is a very effective, with a clearance rate of 94% following a single treatment. In this study no scarring or other complications were reported. [8]

History

The term was coined by American physician William Bennett Bean.[9]

Images
  • Venous lake of the ear
  • Venous lake of the ear

See also

Footnotes
  1. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. Page 588. ISBN 0-7216-2921-0.
  2. Habif, Thomas P. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. Mosby, Inc. 2004. Page 825. ISBN 0-323-01319-8.
  3. Goldberg, LH; Ar, Altman (1985). "Venous lakes of the ears". Cutis. 36 (6): 472–5. PMID 4075841.
  4. Sauer, Gordon. Manual of Skin Diseases. Lippincott. 1985. Page 315. ISBN 0-397-50668-6.
  5. Kuo, HW; Yang, CH. (2003). "Venous lake of the lip treated with a sclerosing agent: report of two cases". Dermatol. Surg. 29 (4): 425–8. doi:10.1046/j.1524-4725.2003.29101.x. PMID 12656828.
  6. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 1620. ISBN 1-4160-2999-0.
  7. Wolff and Johnson. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology. The McGraw-Hill Companies. 2005. Page 192. ISBN 0-07-144019-4.
  8. Bekhor, Philip (11 Sep 2006). "Long-pulsed Nd:YAG laser treatment of venous lakes: report of a series of 34 cases". Dermatologic Surgery. 32 (9): 1151–4. doi:10.1111/j.1524-4725.2006.32253.x. PMID 16970696.
  9. Mulliken, John B. (2013). "13. Capillary malformations, hyperkeratotic stains, telangiectasias, and miscellaneous vascular blots". In Mulliken, John B.; Burrows, Patricia E.; Fishman, Steven J. (eds.). Mulliken and Young's Vascular Anomalies: Hemangiomas and Malformations (2nd ed.). Oxford University Press. p. 553. ISBN 978-0-19-972254-9.
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