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D I A G N O S I S: superf icia l lymphatic m a l f o r m a t i o n ( l y m p h a n g i o m a circumscriptum) Formerly and still commonly called "lymphangioma circumscriptum," a bet- ter name for this condition is "superficial lymphatic malformation" because the lesions a re a congenita l ma lforma- tion of the superficial lymphatics and not tumors. They appea r a s g rouped vesicles and papules, usually with clear fluid. Sometimes they can have a small amount of blood in the vesicles, from vascular connections, and they can appear pink, red, purple or dark blue as some of the vesicular-papules do in this case. If punctured, they can often produce/exude Make a referral today. stdavidscenter.org/referral East African Autism Day Treatment A 28¦YE AR¦OLD WOMAN PRESENTS WITH STR ANGE BUMPS ON HER STOMACH THAT HAVE BEEN PRESENT A S LONG A S SHE CAN REMEMBER. Case of the Month with Crutchfield Dermatology a clear, straw-colored lymph fluid. It is usually localized to a solitary region. Common sites of superficial lymphatic malformation/lymphan- gioma circumscriptum are the abdomen, legs, scrotum/vulva, axillae and tongue. Tex tbook s of t en descr ibe super f icia l lymphatic malformation/lymphangioma cir- cumscriptum as appearing like "frog-spawn." Sometimes the lesions can appear slightly verrucous and can be mistaken as flat warts, molluscum and even small epidermal nevi. Super f icia l ly mphatic ma lfor mation / ly mph a n g iom a ci rc u m scr ipt u m r a rely changes over time. The condition is often associated with a deep component involving the subcutane- ous tissue and even muscle. These deeper components may also have small vascular cone connections. This makes treating superficial lymphatic ma lformation/lymphangioma circumscriptum, superficially, especially challenging when the deeper components are present. Most patients are not bothered by superfi- cial lymphatic malformation/lymphangioma circumscriptum. In cases in which the lesions are painful, drain or are cosmetically unac- ceptable, many experts suggest an imaging study to assess if there is a deep component. If there is only a superficial presence, laser ablation has been repor ted to work well. With deep involvement, repor ts indicate that surgical excision has had good but not always perfect results. In this particular case, the patient was only curious as to what "the group of bumps" were. She wanted no treatment and said a previous physician had frozen them multiple times, without e•ect, calling them molluscum. For more information, contact Charles E. Crutchfield III, MD, at Crutchfield Dermatology or visit CrutchfieldDermatology.com. ■ M D N E W S . C O M /// M D N E W S M I N N E S O TA ■ 2 018 D I A G N O S T I C S ❰❰❰❰❰ 2 3