Venous Lakes Clinical Presentation

Updated: Mar 22, 2022
  • Author: Claudia Hernandez, MD, FAAD; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

Venous lakes most commonly occur in adults older than 50 years with a history of long-term sun exposure. The typical presentation is a slow-growing asymptomatic lesion. Patients with venous lakes may report that the papule has been present for several years prior to presentation. Recurrent bleeding after minor trauma may also be reported.

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Physical Examination

Physical examination usually reveals a soft, compressible, dark-blue or violaceous papule (slightly elevated lesion), up to 1 cm in diameter. Venous lakes usually are well demarcated, with a smooth surface. Compression often causes a emptying of the blood content. Venous lakes 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, as shown in the image below. Another common site of involvement is the vermilion border of the lower lip, shown below. Sometimes, several lesions are found on the same person, and the surrounding skin reveals actinic damage, as shown below.

Venous lake on the helix of the ear. Venous lake on the helix of the ear.
Venous lake on the lower lip. Venous lake on the lower lip.
Venous lake of the lip. Note the apparent actinic Venous lake of the lip. Note the apparent actinic damage of the surrounding skin. Courtesy of Albert C. Yan, MD.
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Complications

Venous lakes are almost always cutaneous conditions. However, there have been 2 reports in the literature of venous lakes found in bowel. In the first case, the venous lake was located in the transverse colon and was found in the upper jejunum in the second. These lesions may be sources of bowel bleeding. [2, 3]  

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