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Venous lake on my lip

By December 23, 2008 - 8:20am
 
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I have this dark blue/purple lesion on my lip that keeps getting bigger. I went to see the dermatologist and she said that it's a venous lake. She said it was nothing I had to worry about. Does anyone else have one or know of someone who does? If so, what was your/their treatment?

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I googeled it & here's what I foung

Background
Venous lakes manifest as dark blue-to-violaceous compressible papules caused by dilation of venules. They were first described in 1956 by Bean and Walsh, who noted how they can be easily compressed and their tendency to occur on sun-exposed skin, especially the ears of elderly patients. Although venous lakes may be considered clinically insignificant from a biological standpoint, they are important because of their mimicry of more ominous lesions, such as melanoma and pigmented basal cell carcinoma.

Pathophysiology
Vascular anomalies are classified into various groups, including malformations, hamartomas, vascular ectasias, vascular hyperplasias, and benign and malignant neoplasms. Venous lakes represent a form of vascular ectasia (vascular dilatation). This group of diseases also includes spider angiomas and telangiectases. A capillary aneurysm is considered a precursor or variant of a venous lake.

The development of venous lakes is believed to be exacerbated by solar exposure and damage. One theory is that chronic solar damage injures the vascular adventitia and the dermal elastic tissue, permitting dilatation of superficial venous structures.

Vascular thrombosis also may play a role in the development of these lesions because thrombosis is commonly present in lesions of this type. Whether thrombosis is a primary or a secondary event in the development of these lesions is unclear.

Frequency
United States
The incidence of disease in the United States is not believed to differ from the incidence worldwide.

International
Although the exact incidence is unknown, venous lakes are common.

Mortality/Morbidity
Mortality from venous lakes has not been reported. There is very little associated morbidity, and lesions typically are considered biologically harmless. Venous lakes are usually asymptomatic, although pain, tenderness, and excessive bleeding can occur once a lesion has been traumatized.

Race
No racial predilection has been documented.

Sex
Bean and Walsh reported that 95% of venous lakes were observed in males. Another review of venous lakes confirmed the same gender distribution. It has been suggested that the disproportionately male distribution may be related to occupational sun exposure, hair length, and hairstyles. Women comprised the majority of treated patients in a large study of laser therapy for venous lakes; however, this may be related to increased concern among women regarding cosmetic appearance rather than with true incidence (a selection bias).

Age
Venous lakes have been reported only in adults and usually occur in patients older than 50 years. The average age of presentation has been reported to be 65 years.

Clinical
History
Venous lakes occur most commonly in adults older than 50 years with a history of chronic sun exposure. The typical presentation is as an asymptomatic lesion.

Physical
Physical examination usually reveals a soft, compressible, violaceous papule, up to 1 cm in greatest diameter. The lesions usually are well demarcated with a smooth surface, and compression often causes a transient depression. Lesions typically are distributed on the sun-exposed surfaces of the face and neck, especially on the helix and antihelix of the ear and the posterior aspect of the pinna (see Image 2). Another common site of involvement is the vermilion border of the lower lip (see Image 3). Sometimes, several lesions are found on the same person, and the surrounding skin reveals actinic damage (see Image 1).

Causes
Solar elastosis is believed to contribute to the development of venous lakes via alteration of vascular and dermal elastic fibers.

December 23, 2008 - 8:30am
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