Venous lake

Author: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, December 2017.

What is a venous lake?

A venous lake is a common bluish soft macule or papule due to vascular dilatation. It is most often seen on the lower lip.

See more images of venous lakes ...

Who gets a venous lake?

Venous lake is most often diagnosed in middle-aged or older males and females of any race.

What is the cause of a venous lake?

The cause of venous lake is unknown.

What are the clinical features of venous lake?

Venous lake is a soft, squashable, blue or purple macule or papule, 0.2 to 1 cm in diameter. Although they may arise anywhere, most venous lakes are diagnosed on the lower lip (vermilion or mucosal surface), on an ear lobe, or elsewhere on face, neck or upper trunk.

How is venous lake diagnosed?

Venous lake is usually easy to diagnose clinically by its appearance. The colour disappears on compression due to clearance of blood from the dilated venule. This is most easily seen using a glass slide or the lens of a contact dermatoscope. It has a structureless blue or purple appearance on dermatoscopy. Biopsy is rarely necessary, and shows a dilated venule.

What is the differential diagnosis of venous lake?

Venous lake may occasionally be confused with:

What is the treatment of venous lake?

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. Methods include:

Surgical excision is rarely necessary and inevitably leaves a scar.


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