By Gary M. White, MD
The venous lake is a common vascular bleb in older patients.
A dome-shaped, dark blue to purple, blood-filled papulonodule is seen. It is easily compressed. It is most common in the lips and ears. Compressing it and removing the purple confirms the diagnosis. Once formed, lesions persist throughout life. Although these lesions are usually asymptomatic, they can bleed if traumatized.
No treatment is needed. Any treatment may potentially leave a scar.
Electrocautery after local anesthesia may be done. For lesions on the lip, cryotherapy with a cryoprobe may be done, although rarely, a pyogenic granuloma may form at the site [BJD 1999;140;358]. The pulsed, tunable-dye and argon lasers have been used as has infrared coagulation. Photocoagulation with high-intensity diode laser is an effective, bloodless procedure for the treatment of VL [Photomed Laser Surg. 2010 Apr;28(2):263-5].
Compressing the lesion and making it disappear confirms the diagnosis.
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