By Gary M. White, MD
A solitary lymphangioma on the face acquired in adulthood.
Lymphangiomas are benign vesicles or blebs of lymphatic tissue. Lymphangioma circumscriptum is a congenital (or soon thereafter) lymphatic malformation of the skin appearing as a group of fluid-filled lymphatic vesicles or blebs. Ninety percent are detected in the first two years of life. The fluid is lymphatic and clear or blood-tinged. Lymphangiomas may also occur later in life on the face, on the chest after mastectomy and radiation therapy or in any location in the setting of chronic lymphedema.
Grouped vesicles with onset from birth to adulthood is characteristic of lymphangioma circumscriptum. It may be congenital (90% onset first two years of life) and large or acquired and small. The tongue is a common site. Oozing, crusting, swelling, pain and itch are not uncommon. The fluid may be blood-tinged or show a blood/fluid line. These lesions often communicate with deeper lymphatics which may explain why simple destruction commonly leads to recurrence. Lesions may occur in the genital area.
No treatment is necessary. Simple destruction , e.g. electrodesication or surgical excision may be tried. The fractional 10,600-nm carbon dioxide (CO2) laser and if the fluid is blood tinged, the tunable dye laser have been used.
Lesion of right buttock. A case of lymphangioma circumscriptum successfully treated with electrodessication following failure of pulsed dye laser. Dermatology Online Journal 19(3)
Lesion on the tongue. Contemporary Clinical Dentistry
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