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June 1994

Picture of the Month

Author Affiliations

From the Department of Dermatology, National Naval Medical Center, Bethesda, Md (Drs Mackey and Yeager), and The Walter Reed Army Institute of Research, Washington, DC (Dr Smith).

Arch Pediatr Adolesc Med. 1994;148(6):609-610. doi:10.1001/archpedi.1994.02170060063011

THE ADOLESCENT boy pictured in the figures has had lesions in this area since birth. The vesicles, limited to the left shoulder and axilla, have enlarged and have become more numerous throughout these years. They are slightly pruritic. During the past 2 years, several of the vesicles have intermittently become hemorrhagic and have discharged clear fluid. The patient has been in excellent health. No other family members have similar lesions.

The vesicles are unilocular and multilocular, ranging from 1 mm to 5 mm, and involve the left posterior axilla and left lateral scapular area (Figure 1 and Figure 2). A prepared punch biopsy specimen is pictured in Figure 3 and Figure 4.

Denouement and Discussion 

Lymphangioma Circumscriptum  Lymphangiomas are hamartomatous malformations made up of dilated lymphatic channels. The lesions have been subdivided into various types throughout the years, based primarily on appearance and extent of involvement. The most frequently used

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