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Vascular Lesions

Author: Dr Amy Prideaux 

Chief Editor: Dr Daniel Keith

Vascular lesions are mainly angiomas, and are of no threat to general health. They tend to be more common as we age, as well as being relatively easy to diagnose! They are most commonly cherry angiomas or haemangiomas.

Macroscopic Appearance

Vascular lesions can range in colour from pale red to black. An angioma is black when it is thrombosed, and they can become very itchy or painful which may be concerning for patients who are told to look out for these changes.

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This lady was referred for this purple papule on her shoulder

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This lesion was referred as a 'dark mole' in the groin that was originally pink, but suddenly became black and sore.

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A further macroscopic example

Dermoscopic Appearance

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Under dermoscopy the classical vascular lacunae can be seen (black arrow).

 

These are often described as a bunch of grapes and the colours can vary from pink and purple in colour, to black.

 

Black angiomas may look scary but these actually normally drop off themselves.

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Under dermoscopy in this unannotated example you can clearly see the vascular lacunae and the colour confirming it as blood

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Under dermoscopy in this unannotated example, the vascular lacunae can be seen clearly. However, in this case the lesion is thrombosed which causes the black colour.

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Another feature which you may see in vascular lesions are white tram lines. These are very obvious in this unannotated example, as well as also having lots of vascular lacunae present.

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Annotated version of the same image. Although this isn't the best quality, you can still appreciate the vascular lacunae present throughout the lesion. They are more clear towards the periphery of the lesion in this example.

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This annotated example of the same lesion highlights some of the more obvious vascular lacunae which in this case are black and thrombosed (yellow circles).

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The features are more clearly highlighted here in this annotated version of the same lesion.

  • Vascular lacunae (yellow circles)

  • White tram lines (blue lines)

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