Venous lake

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD's medical weight loss NYC, sleep center NYC
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Venous lake
Venous lake on the lip
Synonyms	Phlebectasis
Pronounce	N/A
Specialty	N/A
Symptoms	Dark blue to violaceous soft papule
Complications	Bleeding if traumatized
Onset	More common in older adults
Duration	Chronic
Types	N/A
Causes	Sun exposure, aging
Risks	Ultraviolet radiation
Diagnosis	Clinical diagnosis, dermatoscopy
Differential diagnosis	Melanoma, Basal cell carcinoma, Angiokeratoma
Prevention	Sun protection
Treatment	Laser therapy, electrosurgery, cryotherapy
Medication	N/A
Prognosis	Excellent
Frequency	Common in older adults
Deaths	N/A

Close-up of a venous lake on the ear.

Venous lake on the face.

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.

See also

• Cherry angioma
• Spider angioma
• Hemangioma