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]
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.
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