Dermatology: Practical and Conceptual


20 Letter  |  Dermatol Pract Concept 2019;9(1):5

Dermatology Practical & Conceptual

A 56-year-old woman presented with a 5-year history of 

a single, painless, bluish swelling (Figure 1) over the inner 

aspect of the upper lip that began as a pea-sized lesion and 

gradually increased to the present size. There was no history 

of trauma or spontaneous bleeding. On examination, a single, 

violaceous, soft, compressible, nonindurated, nonpulsatile 

papule was present on the inner aspect of the upper lip. On 

diascopy, the lesion could be emptied of most of its blood 

content. Mucoscopy (polarized, 10×) revealed few red and 

blue lacunae with whitish veil (Figure 2). A diagnosis of 

venous lake was made.

Mucoscopy of a Venous Lake
Abhijeet Kumar Jha1, Juhi Pathak2

1 Department of Skin & V.D., Patna Medical College and Hospital, Patna, Bihar, India

2 Department of Conservative Dentistry and Endodontics, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India

Key words: mucoscopy, venous lake

Citation: Jha AK, Pathak J. Mucoscopy of a venous lake. Dermatol Pract Concept. 2019;9(1):20-21. DOI: https://doi.org/10.5826/
dpc.0901a05

Published: January 31, 2019

Copyright: ©2019 Jha et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which 
permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: None.

Competing interests: The authors have no conflicts of interest to disclose.

Authorship: All authors have contributed significantly to this publication.

Corresponding author: Abhijeet Kumar Jha, MD, Department of Skin & V.D., Patna Medical College and Hospital, Patna, Bihar, India. 
Email: drabhijeetjha@gmail.com

Figure 1. Single bluish swelling on the inner aspect of the upper lip. 

[Copyright: ©2019 Jha and Pathak.]

Figure 2. Mucoscopy (polarized, 10×) reveals few red and blue lacu-

nae with whitish veil. [Copyright: ©2019 Jha and Pathak.]



Letter  |  Dermatol Pract Concept 2019;9(1):5 21

of the lacuna, resulting in half-and-half lacuna [3]. To the 

best of our knowledge, this is the first report on mucoscopy 

in venous lake.

References
1. James W, Berger T, Elston D, eds. Andrews ’Diseases of the Skin: 

Clinical Dermatology. 10th ed. Philadelphia: Saunders; 2005:588.

2. Rapini RP, Bolognia JL, Jorizzo JL, eds. Dermatology. Vol. 2. St. 

Louis: Mosby; 2007:1624.

3. Jha AK, Lallas A, Sonthalia S. Dermoscopy of cutaneous lymphan-

gioma circumscriptum. Dermatol Pract Concept. 2017;7(2):37-38.

Venous lakes, also known as “phlebectases” [1], are small 

(0.2-1 cm), generally solitary, soft, compressible, violaceous 

papules commonly found on sun-exposed areas, predomi-

nantly the vermilion border of the lips and ears. Lesions gen-

erally occur among the elderly [2]. Dermoscopically, venous 

lake can mimic cutaneous lymphangioma circumscriptum 

that displays 2 distinct patterns: yellow lacunae surrounded 

by pale septa without inclusion of blood and yellow to pink 

lacunae alternating with dark red or bluish lacunae, due 

to the inclusion of blood. Few lacunae can contain blood, 

which was characteristically accumulated in the lowest part