Venous Lakes

Updated: Sep 30, 2016
  • Author: Claudia Hernandez, MD, FAAD; Chief Editor: Dirk M Elston, MD  more...
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Overview

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 their compressibility and predilection for sun-exposed skin, especially the ears of elderly patients. [1] Although benign, venous lakes are important because of their mimicry of malignant lesions, such as melanoma and pigmented basal cell carcinoma.

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Pathophysiology

A venous lake is an acquired form of vascular ectasia (vascular dilatation). A capillary aneurysm is considered a precursor or variant of a venous lake.

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Epidemiology

Frequency

The worldwide incidence of venous lakes is unknown, but they are believed to be common.

Race

No racial predilection has been documented for venous lakes.

Sex

Bean and Walsh reported that 95% of venous lakes were observed in males. [1] Another review of venous lakes confirmed the same sex distribution. The disproportionate 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.

Age

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

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Prognosis

The prognosis for venous lakes is excellent. Although venous lakes do not resolve on their own, patients can be reassured that venous lakes do not evolve into something more serious, such as a skin cancer. Mortality from venous lakes has not been reported. Venous lakes are usually asymptomatic, although pain, tenderness, and excessive bleeding may occur if a lesion is traumatized. Venous lakes are considered biologically harmless.

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