|
| Fig. 59.9 A, Venous lake presenting as dark blue-violaceous papule on the cheek. B, Same venous lake demonstrating collapse after compression. |
The differential diagnosis includes a blue nevus, malignant melanoma, tattoo, and venous lake. In this case, the diagnosis of a venous lake can be established by compression of the papule, which will cause collapse of the lesion (Fig. 59-9). Venous lakes, like hemorrhoids, are dilated veins that have lost elasticity of their walls. They are usually 1 to 5 mm in diameter and are typically located on sunexposed surfaces, such as the lips, ears, and face of the elderly. They are very common, with one epidemiologic study of elderly patients finding venous lakes in 12% of those examined. They are of no clinical significance, except that they may mimic malignant melanoma and occasionally become painful or thrombosed. They can be treated by excision, carbon dioxide laser, infrared coagulation, or by the injection of sclerosing agents such as polidocanol.
Kuo HW, Yang CH: Venous lake of the lip treated with a sclerosing agent: report of two cases,
Dermatol Surg 29:425–428, 2003.
