Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
Brief Report
Case Report
Images/Instrument in Dermatology/Dermatosurgery
Letter to the Editor
Living Legends
Looking back in history
Original Article
Resident Forum
Residents Forum
Review Article
Spot the Diagnosis
Tropical Dermatology
Visual Treats in Dermatology
View/Download PDF

Translate this page into:

Visual Treats in Dermatology

Lymphangioma circumscriptum under the dermatoscope

Department of Dermatology and Sexually Transmitted Diseases, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
Corresponding author: Prakhar Srivastava, Department of Dermatology and Sexually Transmitted Diseases, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Srivastava P, Khunger N. Lymphangioma circumscriptum under the dermatoscope. CosmoDerma 2022;2:63.

A 6-year-old girl presented with multiple, asymptomatic, fluid-filled lesions, on the right arm since early childhood. Examination revealed multiple, discrete, 0.2–0.3 mm, clear fluid-filled, and hemorrhagic vesicles, present in clusters, over right cubital fossa [Figure 1a]. Dermatoscopy showed multiple white, red, and blue, round to oval lacunae; separated by white lines [Figure 1b]. Some of the lacunae showed color transition; red at the bottom and white at the top [Figure 1c]. Based on history, examination, and dermatoscopy, a diagnosis of lymphangioma circumscriptum was made.

Figure 1:: (a) Multiple, discrete, clear fluid-filled, and hemorrhagic vesicles of lymphangioma circumscriptum present over right cubital fossa. (b) Dermatoscopy showing white lacunae (white arrow), red lacunae (red arrow), and blue lacunae (blue arrow), separated by white lines or septae (yellow arrow) (DermLite DL3N, polarized, dry, contact dermatoscopy, ×10). (c) Dermatoscopy showing hypopyon sign (DermLite DL3N, polarized, dry, contact dermatoscopy, ×10).

Lymphangioma circumscriptum is a congenital microcystic lymphatic malformation. The white lacunae on dermatoscopy represent lymphatic fluid whereas the red lacunae represent the presence of red blood cells in the dilated lymphatic channels. The blue lacunae represent thrombosis within the lacuna. The color transition in lacunae, called as the two-tone lacunae or the half-and-half lacunae or the hypopyon sign, is due to the sedimentation of blood in the dilated lymphatic channels.[1]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


  1. , , , , , , et al. Dermoscopy of lymphangioma circumscriptum: A morphological study of 45 cases. Australas J Dermatol. 2018;59:e189-93.
    [CrossRef] [PubMed] [Google Scholar]

Fulltext Views

PDF downloads
View/Download PDF
Download Citations
Show Sections