70 year old woman with nose lesion

70 year old woman with punch biopsy of left lateral nose with question of blue nevus vs. pigmented basal cell carcinoma vs. melanoma.

Diagnosis: 
Venous lake
Comment: 

Venous lakes are fairly common vascular ectasias presenting on sun damaged skin of the elderly, showing a predilection for the lip.

Lesions may be multiple and measure up to 1 cm in diameter.

The pathogenesis may be due to possible defective stromal support.

 

Microscopic features: dilated and congested veins in the superficial dermis.  No evidence of vascular proliferation.  

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