Patient Story
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.
Introduction
Epidemiology
- 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 201-5
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.)
Etiology and Pathophysiology
- Venous lakes are benign dilated vascular channels (Figure 201-1).
- Cherry angiomas are common benign vascular malformations (see Figure 201-2). They may increase during pregnancy. Several case reports have cited increased cherry angiomas after exposure to toxins.4
- Angiokeratomas are dilated superficial blood vessels that may be associated with increased venous pressure (such as in pregnant patients and patients with hemorrhoids)1 (Figures 201-3 and 201-4).
- Glomangiomas are a distinct type of venous malformation caused by abnormal synthesis of the protein glomulin2
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