Angioma seniles of the lips D18.0

Usually lower lip, less often on the upper lip.

Diffuse, 0.2-0.6 cm large, initially only flat, in a later stage clearly protruding, blue-red pushable away, round or oval, completely symptomless elevation with smooth surface. Phlebectasia of the lower lip is (wrongly) called "senile angioma" or lip margin angioma, although it is often only a conglomeration of capillary ectasia.

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.

• Sclerotherapy: As a first step therapy sclerotherapy can be performed with 1% or 2% Polidocanol injection solution (e.g. Aethoxysclerol). Procedure: Puncture the vasectasia with a fine needle, aspirate the contents and inject 1-2 trps of the sclerosing fluid. Then compress the lip against the teeth for 30 minutes. Repeat sclerotherapy if necessary.
• Excision: If not successful (approx. 30%), surgical removal in LA. Narrow-spindle excision without safety margin. Lateral undermining generally not necessary. Single button sutures with finest skin suture. Notice! The excision lines on the lips must be marked before local anesthesia!
• Laser treatment: CO ₂ laser successful in case studies.

1. Bean WB, Walsh JR (1956) Venous lakes. Arch Dermatol 74: 459-463
2. del Pozo J et al (2003) Venous lakes: a report of 32 cases treated by carbon dioxide laser vaporization. Dermatol Surge 29: 308-310
3. Suhonen R, Kuflik EG (1997) Venous lakes treated by liquid nitrogen cryosurgery. Br J Dermatol 137: 1018-1019