Dilated, thin-walled vascular channels were observed in expanded dermal papillae and the upper reticular dermis; some of them abutted the overlying hyperplastic epidermis, where there was thick, compact orthokeratosis, parakeratosis, and hypergranulosis (Figure 2). Most of the vessels had empty lumina, while some contained scattered erythrocytes and intraluminal fibrin deposits partially lined by endothelial cells (Figure 3). There was a mild perivascular inflammatory infiltrate of lymphocytes, with occasional plasma cells (not shown). These histopathologic findings were consistent with acquired lymphangiectasia of the vulva.