Author: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand. Copy edited by Maria McGivern/Gus Mitchell. December 2017.
A venous lake is a common bluish soft macule or papule due to vascular dilatation. It is most often seen on the lower lip.
Venous lake is most often diagnosed in middle-aged or older men and women of any race.
The cause of venous lake is unknown.
A venous lake is a soft, squashable, blue or purple macule or papule, that is 0.2–1 cm in diameter. Although they may arise anywhere, most venous lakes are diagnosed on the lower lip (on the vermilion margin or mucosal surface), on an ear lobe, or elsewhere on face, neck, or upper trunk.
A venous lake is usually easy to diagnose clinically by its appearance. The colour disappears on compression of the macule or papule due to the clearance of blood from the dilated venule. This is most easily seen using a glass slide or the lens of a contact dermatoscope. A venous lake has a structureless blue or purple appearance on dermoscopy. Biopsy is rarely necessary, and shows a dilated venule.
A venous lake may occasionally be confused with:
A venous lake is harmless and does not require treatment. A lesion that is unsightly can be removed by destroying the lesion. This causes a temporary scab, and the procedure may result in a scar. Treatments to remove a venous lake include:
Surgical excision is rarely necessary and inevitably leaves a scar.
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