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A 31-year-old woman presented with a new swelling on her lower lip. This was clinically recognized as a venous lake (Figure 201-1). The patient was bothered by its appearance and wanted it removed. She chose to have cryotherapy, which eradicated the venous lake. A closed-probe was used on a Cryogun for lesion compression while the freeze was applied using liquid nitrogen.

Figure 201-1

Venous lake on the lip of a young woman. This was eradicated with cryotherapy. (Courtesy of Richard P. Usatine, MD.)

Acquired vascular lesions are common skin findings. They appear “vascular,” or filled with blood. Acquired vascular lesions differ from congenital or hereditary vascular lesions in that they manifest months to years after birth.

  • Venous lakes are acquired vascular lesions of the face and ears.1
  • Cherry angiomas are common vascular malformations that occur in many adults after the age of 30 years (Figure 201-2). Cherry angiomas sometimes proliferate during pregnancy.1
  • Angiokeratomas, the most common form being angiokeratomas of the scrotum (Fordyce) or vulva, develop during adult years (Figures 201-3 and 201-4).1
  • Glomangiomas, also known as glomuvenous malformations or glomus tumors, are a type of rare venous malformation (Figure 201-5). Most patients with glomangiomas are of Northern European descent and have a family history of similar lesions.2
  • Cutaneous angiosarcomas are malignant vascular tumors most commonly found on the head and neck areas of elderly white men. These are rare but deadly (Figure 201-6).3

Figure 201-2

Large cherry angioma treated with shave excision and electrodesiccation of the base. (Courtesy of Richard P. Usatine, MD.)

Figure 201-3

Angiokeratosis on the scrotum. Fordyce spots. (Courtesy of Lewis Rose, MD.)

Figure 201-4

Angiokeratosis on the vulva. This might be mistaken for a melanoma. (Courtesy of Eric Kraus, MD.)

Figure 201-5

Glomangiomas can be multiple or solitary. A. Large glomangiomas of the arm. (Courtesy of Jack Resneck, Sr., MD.) B. Solitary painful glomangioma on the leg of a young man. C. Small solitary painful glomangioma on the arm. These solitary glomangiomas were surgically resected. (Courtesy of Richard P. Usatine, MD.)

Figure 201-6

Angiosarcoma on the nose. A lesion like this requires an urgent biopsy. (Courtesy of Amor Khachemoune, MD.)

  • Venous lakes are benign ...

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