The use of Nd:YAG laser in the treatment of hypertrophic venous lake of the upper lip

According to the ISSVA classification, all vascular anomalies are divided into tumors and malformations. Malformations are divided into venous, lymphatic, capillary and arteriovenous malformations and fistulas. Venous lake (VL) is a special case of venous malformation, which has virtually no communication with the draining veins and is located superficially in the papillary layer of the dermis.1 This formation is often mistakenly called “hemangioma”. VL was first described in 1956 by Bean and Walsh.2 This formation is typical for age-related patients. Clinically manifested by a flat spot of blue or purple color, located at the level of the skin or slightly rising above it. The size of the formation averages from 2 to 10mm.3 Under palpation it soft consistence, painless, under you click is emptied, but under omission finger again is filled with blood (color is returning). Microscopically, the VM is an expanded vein containing several channels and located in the papillary layer of the dermis. Most often located in the lips, face, neck and ear, that is, it is the area that most often can be damaged by the sun. In addition, it can be located on the mucous membrane of the cheeks, tongue or gums. Predisposing factors that cause the appearance of VL include: solar damage, chronic trauma, which cause damage to the adventitia of blood vessels or the occurrence of vascular thrombosis.4 This malformation causes significant cosmetic and psychological discomfort5 for the patient, in some cases there may be rapid growth, which is accompanied by the appearance of a defect of the skin over the formation and bleeding, which is accompanied by a pronounced pain syndrome.