By Gary M. White, MD
This biopsy-proven hemangioma had been present for 4 months on this teenage boy's scalp.
A hemangioma is a benign proliferation of vascular tissue on the skin. (An angioma may be derived from either vascular or lymphatic tissue.).
A red to purple vascular papule is typical. Compressing the lesion and squeezing out blood can help confirm the diagnosis. In discriminating a venous hemangioma from a pigmented lesion, the presence of purple color is key.
Hemangiomas are benign and need not be treated. Flat or only slightly raised lesions often are not bothersome. Simple cautery after lidocaine infiltration may be done. Shave excision with histologic examination should be considered if the diagnosis is in question as amelanotic melanoma may occasionally appear similarly.
Hemangiomas usually do not respond to cryotherapy. Pedunculated lesions, like the one pictured above, are easily snipped after infiltration of the underlying skin with lidocaine. It is helpful to have an assistant at the ready, especially when working on the scalp, to hold pressure before you start cauterizing the base.
Occasionally the venous angioma may thrombus.
Compressing to confirm the vascular nature of the lesion
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