Diagnosis: Thrombosed venous lake

QUESTION: What is your diagnosis? DS68

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Comment: Venous lakes are common vascular ectasias. Soft, dark-blue, often multiple, papules

Common site: Ears, face, lips, or neck of the elderly. Minor trauma to the lesions may produce persistent bleeding.

Microscopic: Usually only a single large dilated vascular channel is present, in the upper dermis. Very thin fibrous wall and a flat endothelial lining. Thrombus is sometimes present in the lumen . These lesions appear to represent a dilated segment of a vein or venule.

CONTRAST WITH ANGIOKERATOMA

  • Hemangioma involving upper dermis and extending into overlying epidermis.
  • Epidermal hyperplasia and hyperkeratosis.
  • (Angio + keratinocyte + oma = Angiokeratoma)

 

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Deba P Sarma, MD, Omaha