Venous lake D18.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 10.12.2021

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Synonym(s)

angioma of the lip; lip angioma; Lip Margin Angioma; Lip Phlebectasia; Phlebektasia of the lip; senile angioma of the lips; vasectasia of the lip; Venous lake

History
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Bean and Walsh, 1956

Definition
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Varicose vascular ectasia(phlebectasia, blood lake), which presents as a lentil- to pea-sized, completely asymptomatic , dark purple, flatly protuberant, usually completely expressible soft elevation.

Manifestation
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After the age of 40.

Localization
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Usually lower lip, less often on the upper lip.

Clinical features
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0.2-0.6 cm in size, initially only flat, in a later stage also distinctly protruding, blue-red, usually completely pushable away, round or oval, completely asymptomatic. soft elevation with a smooth surface. Phlebectasia of the lower lip is (wrongly) called "senile angioma" or lip margin angioma, because it is only a conglomeration of ectatic, capillary or venous vessels.

Histology
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Venektasia (dilated venules or communicating capillary ectasia) in the upper dermis, lacunar cavities with thin walls and focal smooth muscle actin-positive muscle cells and pericytes. Also fresh or older thrombi.

Therapy
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Sclerotherapy: As first step therapy sclerotherapy with 1% or 2% polidocanol injection solution (e.g. Aethoxysklerol) can be performed. Procedure: Puncture the vascular ectasia flatly with a fine needle, aspirate the contents, inject 1-2 trp. of the sclerosing fluid. Then compress the lip against the dentition for 30 minutes. Repeat sclerotherapy if necessary (Cebeci D et al. 2021).

Excision: If unsuccessful (approximately 30%), surgical excision in LA. Narrow spindle excision without safety margin. Lateral undermining usually not necessary. Single button sutures with finest skin suture. Notice. The excision lines on the lips must be marked before local anaesthesia!

Laser treatment: CO 2 laser successful in case studies.

Literature
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  1. Bean WB, Walsh JR (1956) Venous lakes. Arch Dermatol 74: 459-463
  2. Cebeci D et al. (2021) Venous Lakes of the Lips Successfully Treated With a Sclerosing Agent 1% polidocanol: analysis of 25 report cases. Int J Surg Case Rep 78:265-269.
  3. del Pozo J et al. (2003) Venous lakes: a report of 32 cases treated by carbon dioxide laser vaporization. Dermatol Surg 29: 308-310
  4. Mangal S et al (2014) Senile hemangioma of the lips. Indian J Dermatol 59:633.
  5. Suhonen R, Kuflik EG (1997) Venous lakes treated by liquid nitrogen cryosurgery. Br J Dermatol 137: 1018-1019.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 10.12.2021