Venous lake

Venous Lake

A venous lake is a type of vascular lesion that appears as a soft, compressible, dark blue to violaceous papule. These lesions are commonly found on sun-exposed areas of the skin, particularly on the lips, face, and ears of older adults. Venous lakes are benign and are caused by a dilation of venules, which are small veins.

Presentation

Venous lakes typically present as solitary or multiple lesions that are usually asymptomatic. They are often discovered incidentally during a physical examination. The lesions are soft to the touch and can be compressed, which may cause them to blanch temporarily. They are most commonly found in areas that have been exposed to the sun, such as the vermilion border of the lips, the helix of the ear, and the face.

Pathophysiology

The exact cause of venous lakes is not well understood, but they are thought to result from chronic sun exposure and the subsequent damage to the dermis. This damage leads to the dilation of venules, resulting in the characteristic appearance of the lesion. The condition is more prevalent in older adults, likely due to cumulative sun exposure over time.

Diagnosis

Diagnosis of a venous lake is primarily clinical, based on the appearance and location of the lesion. Dermoscopy can be used to aid in diagnosis, revealing a homogeneous blue to purple color. In some cases, a biopsy may be performed to rule out other conditions, such as melanoma or basal cell carcinoma.

Treatment

Treatment is generally not necessary for venous lakes unless they cause cosmetic concern or discomfort. Options for treatment include:

• Laser therapy, such as pulsed dye laser or Nd:YAG laser, which can effectively reduce the appearance of the lesion.
• Cryotherapy, which involves freezing the lesion with liquid nitrogen.
• Electrosurgery, which uses electrical current to remove the lesion.

Prognosis

Venous lakes are benign and do not pose any significant health risk. They do not typically progress to malignancy. However, they may recur after treatment, especially if the underlying cause, such as sun exposure, is not addressed.

Related Pages

• Cherry angioma
• Spider angioma
• Hemangioma

Images

A venous lake on the lip.

Close-up of a venous lake on the ear.

Venous lake on the face.

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  Venous lake on the lip
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  Close-up of a venous lake
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  Venous lake on the ear